Ann Emerg Med:大多数高血压相关的急诊就诊是不必要的

2016-07-16 Seven L 译 MedSci原创

近期发表在Annals of Emergency Medicine的研究数据显示,增加对血压的家庭监测,可能会导致不必要的急诊(ED)就诊。新宁保健科学中心急救医生Clare Atzema博士和同事对加拿大安大略2002-2012年主要诊断为高血压的206147名(平均年龄为64岁)患者的ED数据进行了研究分析。大多数患者(81.4%)有高血压病史,一些患者有糖尿病(20.9%)、慢性阻塞性肺疾病

近期发表在Annals of Emergency Medicine的研究数据显示,增加对血压的家庭监测,可能会导致不必要的急诊(ED)就诊。

新宁保健科学中心急救医生Clare Atzema博士和同事对加拿大安大略2002-2012年主要诊断为高血压的206147名(平均年龄为64岁)患者的ED数据进行了研究分析。大多数患者(81.4%)有高血压病史,一些患者有糖尿病(20.9%)、慢性阻塞性肺疾病(16.5%)、心衰(7.4%)、既往急性心肌梗死(4.6%)和脑卒中(2.6%)等。

数据显示,在研究期间,因高血压就诊ED的患者从每年的15793增加到每年25950人,增长了64.3%(平均每年增加6.2%; 95% CI, 5.5-7),但是住院率却从9.9%下降到7.1%,相对减少28%。在就诊ED的患者中,导致住院的病因主要是卒中(5.3%)、肾功能衰竭(5.2%)和心衰(3.1%)。

对死亡率数据分析显示,在第7天、30天、90天、1年和2年时的死亡率分别为0.17%、0.43%、0.85%、2.5%和4.4%;研究期间所有的死亡率结果均在下降(P < 0.001)。

研究人员说,当然这项研究也存在自身的局限和不足,比如大多数患者是偶然发现高血压,这并不意味着随访的时候会得到相同的诊断。

研究人员写道:“卒中仍是高血压相关的重要‘杀手’,得益于血压监测让我们能够及早的防治。对于患者应该了解并认识与高血压相关的医疗急救症状,如胸痛、严重的头痛、恶心或呼吸急促,避免不必要的急诊就诊。”

原始出处:


Masood S, et al. A Population-Based Analysis of Outcomes in Patients With a Primary Diagnosis of Hypertension in the Emergency Department.Ann Emerg Med. 2016;doi:10.1016/j.annemergmed.2016.04.060.

ED visits for hypertension, many unnecessary, increasing
.Healio.July 15, 2016

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    2016-09-25 1e10c84am36(暂无匿称)

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    2016-07-18 doctorJiangchao

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