Abstract FR572: Hospital Characteristics on Outcomes of Patients With Hypertensive Emergency: A National Inpatient Analysis

Introduction: Hypertensive emergency, marked by acutely elevated blood pressure severe enough to cause end-organ damage, requires prompt hospitalization and adequate control. While individual patient risk factors and adverse outcomes have been extensively studied, less is known about how hospital characteristics and structure influence outcomes of hypertensive emergencies. This study aims to explore possible correlations to gather a more comprehensive understanding. Hypothesis: We hypothesized that hospital size, teaching status, and private versus public ownership independently have significant impacts on inpatient all-cause mortality as well as length of stay. Methods: We conducted a retrospective cross-sectional study using the 2020-2021 National Inpatient Sample database, including adult patients with a diagnosis of hypertensive emergency (International Classification of Diseases, Tenth Revision code I16.1). Hospital characteristics included bed size (small, medium large), location associated with teaching status (rural, urban non-teaching, urban-teaching), and private versus public ownership. Primary outcomes assessed were all-cause inpatient mortality and length of stay. Survey-weighted generalized linear models estimated associations between hospital characteristics and each outcome, with regression models applied for each primary outcome. Results: A total of 118,133 adult admissions for hypertensive emergencies were included after excluding patients with missing data. After adjustment, analysis showed that urban teaching hospitals were associated with almost twice the odds of inpatient mortality (95% CI 1.72-2.38) and a 2.71-day longer inpatient stay (95% CI 2.48–2.95) compared to rural hospitals. Large hospitals also had almost twice the odds of mortality (95% CI 1.84–2.20) and a 2-day longer stay (95% CI 1.87–2.15) compared to small hospitals. Public hospitals were associated with a shorter LOS by 0.40 days (95% CI –0.56 to –0.23) but did not show a significant difference in mortality. Conclusion: Large hospitals and teaching hospitals were seen to have an increase in inpatient mortality and length of stay. These findings suggest that hospital infrastructure may play a role in adverse outcomes, highlighting a possible need for system-level evaluation and resource optimization for efficient and effective patient care.