Annals of Emergency Medicine
Volume 43, Issue 1 , Pages 106-113 , January 2004

Nontraumatic out-of-hospital hypotension predicts inhospital mortality

  • Alan E Jones, MD

      Affiliations

    • Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC, USA
    • ,
  • Ian G Stiell, MD, MSc

      Affiliations

    • Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada
    • ,
  • Lisa P Nesbitt, MHA

      Affiliations

    • Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada
    • ,
  • Daniel W Spaite, MD

      Affiliations

    • Department of Emergency Medicine, University of Arizona, Tucson, AZ, USA
    • ,
  • Nael Hasan, MD

      Affiliations

    • Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC, USA
    • ,
  • Brian A Watts, EMT-P

      Affiliations

    • Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC, USA
    • ,
  • Jeffrey A Kline, MD

      Affiliations

    • Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC, USA
    • Corresponding Author InformationAddress for reprints: Jeffrey A. Kline, MD, Department of Emergency Medicine, 1000 Blythe Boulevard, MEB 304D, Carolinas Medical Center, Charlotte, NC 28203; 704-355-8155, fax 704-355-7047

Received 18 June 2003 ,Revised 19 August 2003 ,Accepted 26 August 2003.

References 

    References
  1. Moore CL, Rose GA, Tayal VS, et al.  Determination of left ventricular function by emergency physician echocardiography of hypotensive patients. Acad Emerg Med. 2002;9:186–193
  2. O'Brien E, Beevers G, Lip GY. ABC of hypertension: blood pressure measurement, part IV: automated sphygmomanometry: self blood pressure measurement. BMJ. 2001;322:1167–1170
  3. Stiell IG, Wells GA, Spaite DW, et al.  The Ontario Prehospital Advanced Life Support (OPALS) study, part II: rationale and methodology for trauma and respiratory distress patients: OPALS Study Group. Ann Emerg Med. 1999;34:256–262
  4. Efron B, Tibshirani R. Improvements on cross-validation: the 632+ bootstrap method. J Am Stat Assoc. 1997;92:548–560
  5. Lee KL, Woodlief LH, Topol EJ, et al.  Predictors of 30-day mortality in the era of reperfusion for acute myocardial infarction: results from an international trial of 41,021 patients: GUSTO-I Investigators. Circulation. 1995;91:1659–1668
  6. Goldhaber SZ, Visani L, De Rosa M. Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet. 1999;353:1386–1389
  7. McCaig LF, Ly N. National Hospital Ambulatory Medical Care Survey: 2000 emergency department summary. In: Advance Data From Vital and Health Statistics. No. 326. Hyattsville, MD: National Center for Health Statistics; 2002;
  8. Knudson MM, Lieberman J, Morris JAJ, et al.  Mortality factors in geriatric blunt trauma patients. Arch Surg. 1994;129:448–453
  9. Chan L, Bartfield JM, Reilly KM. The significance of out-of-hospital hypotension in blunt trauma patients. Acad Emerg Med. 1997;4:785–788
  10. Franklin GA, Boaz PW, Spain DA, et al.  Prehospital hypotension as a valid indicator of trauma team activation. J Trauma. 2000;48:1034–1037
  11. Hill DA, Abraham KJ, West RH. Factors affecting outcome in the resuscitation of severely injured patients. Aust N Z J Surg. 1993;63:604–609
  12. Knottenbelt JD. Low initial hemoglobin levels in trauma patients: an important indicator of ongoing hemorrhage. J Trauma. 1991;31:1396–1399

☆ Author contributions: AEJ conceived the study, and AEJ and JAK designed the study. AEJ, IGS, LPN, DWS, NH, BAW, and JAK performed data collection. JAK secured internal funding. AEJ, IGS, LPN, DWS, and JAK analyzed the data and prepared the manuscript. AEJ takes responsibility for the paper as a whole.The authors report this study did not receive any outside funding or support.

PII: S0196-0644(03)00928-4

doi: 10.1016/j.annemergmed.2003.08.008

Annals of Emergency Medicine
Volume 43, Issue 1 , Pages 106-113 , January 2004

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