Fatores preditores de mortalidade em indivíduos internados por emergência hipertensiva

Abstract

The Hypertensive Emergency (HE) stands out as a form of acute high blood pressure with target-organ damages (TOD), usually followed by systolic and / or diastolic blood pressure levels ≥ 180/120 mmHg, respectively. Objectives: To identify factors associated with in-hospital mortality in patients admitted to the hospital with TOD, with HE and No-Hypertensive Emergency (NHE). Casuistic and Methods: Crosssectional study carried out with patients treated in a hospital emergency during 06/01/2018 to 12/31/2019 with HE and NEH. The sample comprised 620 individuals (400 with EH and 220 NEH). Results: Patients with HE presented a shorter time between onset of signs and symptoms and attendance, longer hospital stay and higher capillary blood glucose at admission, when compared to those with SEH. Among the 77 deaths observed (12.4% of the sample), 53 occurred in the EH group. When comparing the survivors with the deaths, there was a higher capillary blood glucose and random deaths (p 0.03 and p 0.02, respectively) than those who survived. In the multivariate analysis for mortality, capillary blood glucose, Glasgow coma scale and infection during hospitalization were predictors for in-hospital mortality in the acute event with and without HE. Conclusions: In HE, hyperglycemia is higher and is associated with higher in-hospital mortality. Capillary blood glucose is an isolated or combined predictor for mortality, that is, in the event with HE the cut is 130 mg / dL and in the SEH it is 119.5 mg / dL. However, it is not yet known whether glucose is a marker or mediator of adverse results. Prospective studies focusing on glycemic control are required to ascertain these results.