CLINICAL PROFILE OF PATIENTS WITH HYPERTENSIVE CRISIS IN WOLKITE UNIVERSITY SPECIALIZED TEACHING HOSPITAL ADULT MEDICAL EMERGENCY FROM AUGUST 2021-AUGUST 2022 WOLKITE ETHIOPIA

Abstract

Background; Hypertension is an Increasing public health problem in many developing countries including Ethiopia. The Joint National Committee (JNC) on Prevention, Detection, Evaluation, and Treatment of high BP Reported that chronic hypertension is affecting over 2.8 billion Individuals worldwide. Uncontrolled hypertension, may lead to hypertensive crises, consisting of hypertensive Urgencies or Emergencies with or without End organ damage respectively. There is a paucity of data on patients in hypertensive crises presenting to emergency departments in southern Ethiopia including the ED of WUSTH. Objective; to assess the clinical profile of patients presented with Hypertensive Crisis to WUSTH medical emergency From August 2021-August 2022Methodology; an institution based retrospective cross-sectional study was conducted by reviewing records with diagnosis of hypertensive crisis with systolic/diastolic BP raised to >180/110 mmHg admitted to WUSTH from August 2021- August 2022. Patient‟s medical records with complete information wereenrolled consecutively. Socio-demographic, clinical character, and other related variables were collected using a structured checklist. Data was cleaned, entered and analyzed using SPSS version 23. The study findings were summarized using mean, median, frequency and proportions and presented by texts, graphs and tables.Result; A total of 215/2629(8.1%) patient medical records were included in the analysis. The majority were males 116(53.41%). The mean age of the entire patients was 56 ± 16.483. 142(60%) of patients have a documented history of hypertension and on antihypertensive drugs. The majority of cases 117/215(54.4%) were hypertensive urgencies. The most common presenting signs and symptoms at admission were headache (n = 61, 28.4%), extremity weakness (48/215, 22.3%) and change in mentation (27/215, 12.5%). RFT, ECG, CXR and brain CT were commonly requested investigations. Nifedipine (94/215) and Captopril (67/215) were the most commonly prescribed oral drugs; Whereas, IV Lasix (10/215) was the most commonly prescribed IV drug for acute BP control. Eight (3.7%) patients died at ED. Almost all hospital mortality was attributed to hypertensive emergencies, stroke accounting for 60% of cases. Conclusion; in our retrospective study of adult patients with hypertensive crisis hypertensive emergency was related with substantial morbidity and mortality. Hence, hypertensive patients should be strictly managed accordingly, and promoting early screening programs could reduce the risk of TOD .Thus this study recommends further researches to be done to determine the etiology, pathophysiology and the most appropriate strategies for prevention and management of hypertensive crisis.