title: Predictors of 90-day readmission among patients with acute severe hypertension. The cross-sectional observational Studying the Treatment of Acute hyperTension (STAT) study.
abstract: BACKGROUND
  Acute severe hypertension can be a life-threatening emergency. The objective of this study was to describe the frequency of rehospitalization for patients with acute severe hypertension and to identify clinical predictors of 90-day rehospitalization.
  
  
  METHODS
  In this observational cross-sectional study, consecutive patients were identified retrospectively (January 2007 to April 2008) through uniform data query of hospital pharmacy databases in 25 hospitals in the United States. Eligible patients were > or =18 years old, had systolic blood pressure >180 mm Hg and/or diastolic blood pressure >110 mm Hg, and had received intravenous antihypertensive therapy within 24 hours of presentation. Data were collected on patient demographics, medical history, laboratory findings, antihypertensive therapies, resource utilization, hospital-associated events, readmission within 90 days of hospital discharge, and death up to 6 months following the index hospitalization.
  
  
  RESULTS
  The 90-day readmission rate was 35% (354/1,009) of patients discharged home alive and with known readmission status; 41% (144/354) were readmitted more than once. Of these 354 patients, readmission was for acute severe hypertension in 29% (n = 101). Eighteen (1.9%) patients died between hospital discharge and 90 days. Factors associated with readmission for hypertension included previous hospitalization for acute severe hypertension, history of drug abuse, and presenting with seizures or shortness of breath. Patients with an admitting diagnosis of hypertension were 94% more likely to be readmitted.
  
  
  CONCLUSIONS
  More than one third of patients discharged home after hospitalization for severe hypertension were rehospitalized at least once within 90 days, more than one quarter for acute severe hypertension. Further studies are warranted to determine the impact of other variables on readmission rates and clinical outcomes in this population.
authors.affiliation: University of Massachusetts Medical School, Worcester, 01605, USA. joel.gore@umassmemorial.org
authors.forename: Joel M
authors.initials: JM
authors.lastname: Gore
authors.forename: Eric
authors.initials: E
authors.lastname: Peterson
authors.forename: Alpesh
authors.initials: A
authors.lastname: Amin
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Anderson
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Dasta
authors.forename: Phillip D
authors.initials: PD
authors.lastname: Levy
authors.forename: Brian J
authors.initials: BJ
authors.lastname: O'Neil
authors.forename: Gene Yong
authors.initials: GY
authors.lastname: Sung
authors.forename: Joseph
authors.initials: J
authors.lastname: Varon
authors.forename: Allison
authors.initials: A
authors.lastname: Wyman
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Granger
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology*; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012008:Recurrence; D012307:Risk Factors
chemical_list: D000959:Antihypertensive Agents