Cardiol Res

Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access

Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc

Journal website https://www.cardiologyres.org

Original Article

Volume 12, Number 3, June 2021, pages 156-160

Review of Referrals Sent to the Emergency Department for Management of Hypertension

Figure 1. Study population. Acute target end-organ damage was defined as heart failure, myocardial infarction, stroke, increased ICP, hypertensive encephalopathy, ruptured major vessel, intracerebral hemorrhage, transient cerebral ischemia, or retinal hemorrhage. Overall patient volume per year was taken from the Montfort emergency room website [3]. ICP: intracranial pressure.

**Table 1.** Demographic Information, Triage Summary and Visit Overview Statistics for Patients Presenting to the Montfort ED Regarding Hypertension During the 2016 Fiscal Year
	Patients presenting to ED	P value
Values were presented as mean ± SD for continuous variables or N (%) for categorical variables. ^aN = 178. ^bN = 65. ^cN = 182. ^dN = 175. ^eN = 66. *Does not include patients admitted to Montfort or transferred to another hospital. ^†Pearson Chi-square analysis. ED: emergency department; SBP: systolic blood pressure; DBP: diastolic blood pressure.
Number of patients	67	187
Gender			0.99^†
Male	24 (35.8)	67 (35.8)
Female	43 (64.2)	120 (64.2)
Age
Male	59 ± 18.4	62 ± 15.0	0.88
Female	72 ± 15.5	64 ± 15.8	0.04
Total	67 ± 17.6	63 ± 15.5	0.10
Mode of arrival			0.005^†
Ambulance	22 (40.8)	31 (16.2)
Other means	45 (59.2)	156 (83.8)
Wait time before seeing MD	205 ± 132.1	197 ± 137.9	0.63
Wait time before discharge*	268 ± 139.3^b	283 ± 135.4^a	0.45
Triage vital signs
SBP	186 ± 24.9	176 ± 26.2	0.006
DBP	99 ± 17.0	91 ± 16.1	0.005
Heart rate (/min)	77 ± 15.7	79 ± 13.7	0.46
Respiratory rate (/min)	17 ± 1.6	17 ± 1.6	0.28
Oxygen saturation (%)	98 ± 1.9	97 ± 6.8^c	0.58
Temperature (°C)	36.6 ± 0.4^b	36.6 ± 0.3^d	0.49
Maximal SBP	193 ± 23.9	183 ± 26.6	0.01
Maximal DBP	101 ± 15.6^e	95 ± 18.2^e	0.04
Patients received an antihypertensive while in ED			0.21^†
Yes	21 (31.3)	44 (23.5)
No	46 (68.7)	143 (76.5)
Patients sent home with antihypertensive prescription			0.48^†
Yes	28 (42.4)	67 (35.8)
No	38 (56.7)	112 (59.9)

Table 1. Demographic Information, Triage Summary and Visit Overview Statistics for Patients Presenting to the Montfort ED Regarding Hypertension During the 2016 Fiscal Year

Patients presenting to ED

P value

Referred by health professionals

Self-referred

Values were presented as mean ± SD for continuous variables or N (%) for categorical variables. ^aN = 178. ^bN = 65. ^cN = 182. ^dN = 175. ^eN = 66. *Does not include patients admitted to Montfort or transferred to another hospital. ^†Pearson Chi-square analysis. ED: emergency department; SBP: systolic blood pressure; DBP: diastolic blood pressure.

Number of patients

187

Gender

0.99^†

Male

24 (35.8)

67 (35.8)

Female

43 (64.2)

120 (64.2)

Age

Male

59 ± 18.4

62 ± 15.0

0.88

Female

72 ± 15.5

64 ± 15.8

0.04

Total

67 ± 17.6

63 ± 15.5

0.10

Mode of arrival

0.005^†

Ambulance

22 (40.8)

31 (16.2)

Other means

45 (59.2)

156 (83.8)

Wait time before seeing MD

205 ± 132.1

197 ± 137.9

0.63

Wait time before discharge*

268 ± 139.3^b

283 ± 135.4^a

0.45

Triage vital signs

SBP

186 ± 24.9

176 ± 26.2

0.006

DBP

99 ± 17.0

91 ± 16.1

0.005

Heart rate (/min)

77 ± 15.7

79 ± 13.7

0.46

Respiratory rate (/min)

17 ± 1.6

0.28

Oxygen saturation (%)

98 ± 1.9

97 ± 6.8^c

0.58

Temperature (°C)

36.6 ± 0.4^b

36.6 ± 0.3^d

0.49

Maximal SBP

193 ± 23.9

183 ± 26.6

0.01

Maximal DBP

101 ± 15.6^e

95 ± 18.2^e

0.04

Patients received an antihypertensive while in ED

0.21^†

Yes

21 (31.3)

44 (23.5)

46 (68.7)

143 (76.5)

Patients sent home with antihypertensive prescription

0.48^†

Yes

28 (42.4)

67 (35.8)

38 (56.7)

112 (59.9)

**Table 2.** Presenting Complaints for Patients Referred to the Montfort ED Regarding Hypertension During the Fiscal Year of 2016
	Referred patients, N (%)	Patients who self-referred, N (%)	P-value
*Includes one of the following symptoms (number of cases): light-headedness (3), epistaxis (2), arm pain (2), abdominal pain (2), tinnitus (1), edema (1), decreased level of consciousness (1), sore throat (1), cough (1), confusion (1), numbness (1) and facial droop (1).
Asymptomatic	25 (37.3)	30 (16.0)	0.50
Headache	25 (37.3)	84 (44.9)	< 0.001
Dizziness	9 (13.4)	43 (23.0)	< 0.001
Chest pain	4 (6.0)	25 (13.4)	0.001
Vertigo	2 (3.0)	1 (0.5)	0.56
Paresthesias	2 (3.0)	1 (0.5)	0.56
Weakness	1 (1.5)	12 (6.4)	0.002
Nausea/vomiting	1 (1.5)	15 (8.0)	< 0.001
Agitation	1 (1.5)	0	-
Fatigue	0	6 (3.2)	-
Other*	0	21 (11.2)	-

Table 2. Presenting Complaints for Patients Referred to the Montfort ED Regarding Hypertension During the Fiscal Year of 2016

Referred patients, N (%)

Patients who self-referred, N (%)

P-value

*Includes one of the following symptoms (number of cases): light-headedness (3), epistaxis (2), arm pain (2), abdominal pain (2), tinnitus (1), edema (1), decreased level of consciousness (1), sore throat (1), cough (1), confusion (1), numbness (1) and facial droop (1).

Asymptomatic

25 (37.3)

30 (16.0)

0.50

Headache

25 (37.3)

84 (44.9)

< 0.001

Dizziness

9 (13.4)

43 (23.0)

< 0.001

Chest pain

4 (6.0)

25 (13.4)

0.001

Vertigo

2 (3.0)

1 (0.5)

0.56

Paresthesias

2 (3.0)

1 (0.5)

0.56

Weakness

1 (1.5)

12 (6.4)

0.002

Nausea/vomiting

1 (1.5)

15 (8.0)

< 0.001

Agitation

1 (1.5)

Fatigue

6 (3.2)

Other*

21 (11.2)