Using the Emergency Department as a Screening Site for High Blood Pressure: A Method for Improving Hypertension Detection and Appropriate Referral
Using the Emergency Department as a Screening Site for High Blood Pressure: A Method for Improving Hypertension Detection and Appropriate Referral
复制标题
使用急诊室作为高血压筛查场所：改善高血压检测和适当转诊的方法
作者：
J. Mamon;Lawrence Green;D. Levine;G. Gibson;H. T. Gurley
本研究描述了一种用于急诊科（艾德）的高血压协议的开发和测试，以提高对那些适合随后转诊的患者的检测。该方案涉及两次连续血压测量和患者访谈，以确定：1）既往高血压（HBP）史，2）过去一年HBP治疗，3）通常的医疗护理来源。通过与患者的住院记录（反映门诊和住院访视）进行比较，验证患者报告的准确性。结果表明，这些自我报告具有高水平的敏感性（范围90-100%）和特异性（范围79-96%）。使用额外的患者信息增加了筛选方案在确定患者何时何地应该转诊方面的敏感性。该方法的应用表明，该方案是一种简单有效的HBP筛查方法。研究结果还表明，艾德是筛查“难以接触”的高血压人群的理想场所。
This study describes the development and testing of a high blood pressure protocol for use in emergency departments (ED) to enhance detection of those patients appropriate for subsequent referral. The protocol involves two serial blood pressure measurements and a patient interview to determine: 1) previous history of high blood pressure (HBP), 2) treatment in past year for HBP, and 3) usual source of medical care. The accuracy of patient reporting was validated by comparison with the patients' hospital record (reflecting outpatient and inpatient visits). Results indicate that these self-reports have high levels of sensitivity (range 90-100%) and specificity (range 79-96%). Use of the additional patient information increased the sensitivity of the screening protocol in identifying when and where a patient should be referred. Use of this methodology indicates that the protocol is a simple and effective method for HBP screening. The findings also suggest that the ED is an ideal site for screening the “hardto- reach” hypertensive population.