What is the clinical evidence from this study?

Study design: Observational. Population: Orthostatic hypotension (n=814). Intervention: Orthostatic hypotension vs. No orthostatic hypotension. Primary outcome: Hospitalization (p=<0.0001).

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January 1, 2006

Assessment of orthostatic hypotension in the emergency room

Q: What are the key findings of this study?

Orthostatic hypotension was present in 25.3% of emergency room patients and was associated with a significantly higher risk of hospitalization compared to those without it (50.9% vs 22.9%, P<0.0001).

Resultado clave

Orthostatic hypotension was present in 25.3% of emergency room patients and was associated with a significantly higher risk of hospitalization compared to those without it (50.9% vs 22.9%, P<0.0001).

Diseño del estudio

Tipo

Observational (n=814)

Multicéntrico

PICO

Población

814 patients (mean age 56.6 years) attending a tertiary-center emergency room over a 2-month period.

Exposición / comparador

Orthostatic hypotension vs No orthostatic hypotension

Resultado principal

Hospitalization, p=<0.0001

Resultado numérico

Tasa de eventos absoluta: 50.9% vs 22.9%

valor p: p=<0.0001

Resumen

The study sought to determine the duration of standing needed to detect most cases of orthostatic hypotension (OH) in the emergency room (ER) and to correlate OH with symptoms, hospitalization and survival. Patients attending a tertiary-center ER within a 2-month period underwent orthostatic tests after 1, 3 and 5 min of standing. OH was defined as a drop of > or = 20 mmHg in systolic pressure or > or = 10 mmHg in diastolic pressure on assuming an upright posture. Of the 814 patients tested (402 men, mean age 56.6 +/- 19.9 years), 206 (25.3%) had OH, detected in most cases (83.5%) after 3 min of standing. OH was associated with significantly higher supine systolic (p = 0.013) and diastolic (p = 0.004) blood pressure, symptoms of syncope (r = 0.11, p < 0.001) or dizziness (r = 0.14, p < 0.0001) and risk of hospitalization (50.9% vs 22.9%, p < 0.0001). Crude mortality was similar between patients with and without OH (13.8% vs 8.7%, p = 0.06). However, on age-adjusted analysis, patients older than 75 years with OH had significantly increased mortality (p = 0.04). In conclusion, 3 min of standing is apparently sufficient for the diagnosis of most cases of OH. Considering the high rate of OH and its predictive value for hospitalization, it should be routinely assessed in all ER patients.

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Cite This Study

Cohen et al. (Sun,) conducted a observational in Orthostatic hypotension (n=814). Orthostatic hypotension vs. No orthostatic hypotension was evaluated on Hospitalization (p=<0.0001). Orthostatic hypotension was present in 25.3% of emergency room patients and was associated with a significantly higher risk of hospitalization compared to those without it (50.9% vs 22.9%, P<0.0001).

synapsesocial.com/papers/6a294cd6f95f9bb4b3a01563 https://doi.org/https://doi.org/10.1080/08037050600912070

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