Incidence, associated clinical factors and outcome of hypertensive crises in critically Ill patients: A prospective survey

Abstract

Background: Hypertensive crises (HCs) are common among critically ill patients. However, little is known of their epidemiology, particularly actual rate and outcome of affected patients. Primary end-point of the study was to assess incidence of and clinical factors associated with HCs in a cohort of patients admitted to a general ICU. Secondary end-point was to assess the impact of HC on patients' outcome. Methods: All patients consecutively admitted to a general ICU over a 13 months period were included in the study. Incidence of HCs was assessed and associated clinical factors were determined using univariate and multivariate analysis. Length-of-stay and ICU- and in-hospital mortality were evaluated. Results: Incidence of HCs was 15.4%. Factors independently associated with HCs were: ICU-admission for acute medical conditions, cigarette smoking, cancer, coronary artery disease, chronic atrial fibrillation (p<0.05). ICU length-of-stay and ICU-/ in-hospital mortality rate were higher among patients with HCs (p<0.05). Conclusion: HCs are common in critically Ill patients, even if previously normotensive, and are associated with a worse outcome. Associated clinical factors include acute medical conditions leading to ICU admission, cigarette smoking, cancer, coronary artery disease and chronic atrial fibrillation. © 2011 Chelazzi C, et al.