Anesthésie et recherche clinique
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Incidence, Associated Clinical Factors and Outcome of Hypertensive Crises in Critically Ill Patients: A Prospective Survey

Cosimo Chelazzi, G. Villa, L. Margiacchi, C. Guido and A.R. De Gaudio

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.C