Treatment Outcome and Associated Factors Among Patients Admitted with Hypertensive Crisis in Public Hospitals at Harar Town, Eastern Ethiopia: A Cross-Sectional Study

Figures & data

Table 1 Patient Characteristics of Emergency Department, Public Hospital, Harar, Ethiopia, 2022

Characteristics	All Patients (N=363)	Hypertensive Emergency (N= 111)	Hypertensive Urgency (N=252)
Sex
Female	125 (34.4%)	28 (22.4%)	97 (77.6%)
Male	238 (65.6%)	83 (34.9%)	155 (65.1%)
Age (years)
<30	102 (28.1%)	37 (36.3%)	65 (63.7%)
30–39	68 (18.7%)	23 (33.8%)	45 (66.2%)
≥40	193 (53.7%)	51 (26.4%)	142 (73.6%)
Residence
Urban	260 (71.6%)	94 (36.2%)	166 (63.8%)
Rural	103 (28.4%)	17 (16.5%)	86 (83.5%)
Pre-existing hypertension
Yes	239 (65.8%)	64 (26.7%)	176 (73.6%)
No	124 (34.1%)	86 (69.4%)	38 (30.6%)
Target organ damage
Acute renal failure	31 (8.5%)	31	0
Hypertensive encephalopathy	18 (5.0%)	18	0
Intracerebral/SAH	12 (3.3%)	12	0
Ischemic stroke	21 (5.8%)	21	0
Acute pulmonary edema	14 (3.9%)	14	0
Retinopathy	15 (4.1%)	15	0
History of previous admission
Yes	252 (69.4%)	16 (6.3%)	236 (93.7%)
No	111 (30.6%)	99 (89.2%)	12 (10.8%)
Length of hospital stay (day)
<7	112 (30.9%)	87 (77.7%)	25 (22.3%)
≥7	251 (69.1%)	203 (80.9%)	48 (19.1%)

Abbreviation: SAH, subarachnoid hemorrhage.

Table 2 Clinical Presentation and Previous Treatment, Public Hospital, Harar, Ethiopia, 2022

Characteristics	All Patients (N=363)	Hypertensive Emergency (N= 111)	Hypertensive Urgency (N=252)
Clinical Presentation
Headache	71 (19.6%)	23 (36.5%)	40 (63.5%)
Dyspnea	45 (12.4%)	28 (62.2%)	17 (37.7%)
Dizziness	63 (17.4%)	16 (25.3%)	47 (74.6%)
Palpitation	57 (15.7%)	19 (33.3%)	38 (67.7%)
Chest pan	50 (13.8%)	36 (72.0%)	14 (28.0%)
Shortness of breath	42 (11.6%)	26 (61.9%)	16 (38.1%)
Vomiting	35 (9.6%)	21 (60.0%)	14 (40.0%)
Before admission on an hypertensive treatment
Yes	239 (65.8%)	26 (10.9%)	213 (89.1%)
No	124 (34.2%)	89 (71.7%)	35 (28.2%)
Before admission regimen
Monotherapy	126 (34.7%)	14 (11.1%)	112 (88.9%)
Combination therapy	113 (31.1%)	12 (10.6%)	101 (89.3%)
Class of antihypertensive drugs taken
Diuretics	65 (17.9%)	4 (6.1%)	61 (93.8%)
CCBs	36 (9.9%)	6 (16.6%)	29 (80.5%)
ACEIs	25 (6.9%)	5 (20.0%)	20 (80%)
CCBs/Diuretics	48 (13.2%)	4 (8.3%)	44 (91.6%)
Diuretics/ACEIs	65 (17.9%)	7 (10.8%)	58 (89.2%)
Compliance to treatment
No	90 (37.7%)	11 (12.2%)	79 (87.7%)
Yes	149 (62.3%)	15 (10.06%)	134 (89.9%)

Abbreviations: CCBs, calcium channel blockers; ACEIs, angiotensin converting enzyme inhibitors.

Table 3 Treatment of Hypertensive Crisis Patients and Laboratory Investigation During Admission, Public Hospital, Harar, Ethiopia, 2022

Treatment	All Patients (N=363)	Hypertensive Emergency (N= 111)	Hypertensive Urgency (N=252)
Oxygen supplementation
Yes	113 (31.1%)	98 (86.7%)	15 (13.3%)
No	250 (68.9%)	26 (10.4%)	224 (89.6%)
Ventilator support
Yes	98 (27.0%)	75 (76.5%)	23 (23.5%)
No	265 (73.0%)	27 (10.2%)	238 (89.8%)
Emergency drug administered during admission
Captopril	255 (70.2%)	30 (11.8%)	225 (88.2%)
Hydralazine	108 (29.8%)	81 (75.0%)	27 (25.0%)
IV fluid supplementation
Yes	150 (41.3%)	122 (81.3%)	28 (18.7%)
No	213 (58.7%)	19 (8.9%)	194 (91.1%)
Investigations
Blood chemistry	58 (15.9%)	46 (79.3)	12 (20.7%)
Complete blood count	77 (21.2%)	60 (77.9%)	17 (22.1%)
Urine analysis	48 (13.2%)	35 (72.9%)	13 (27.1%)
Electrocardiogram	16 (4.4%)	11 (68.8%)	5 (31.2%)
Chest X-ray	19 (5.2%)	13 (68.4%)	6 (31.5%)
CT brain scan	33 (9.0%)	28 (84.8%)	5 (15.2%)
Overall outcome at discharge
Good	265 (73.0%)	53 (20.0%)	212 (80.0%)
Poor	98 (27.0%)	58 (59.2%)	40 (40.8%)

Figure 1 Treatment outcome of hypertensive crisis patients at discharge, Public Hospital, Harar, Ethiopia, 2022.

Table 4 Multivariate Analysis of Factors Associated with Poor Treatment Outcome of Hypertensive Crisis at HFCSH and JGH, Harar, Ethiopia, 2022 admission

Variables	Treatment Outcome		COR (95% CI)	AOR (95% CI)	P-value
	Good (%)	Poor (%)
Sex
Female	106 (84.8)	19 (15.2)	2.8 (1.6–4.8)	3.4 (1.7–7.9)	0.01*
Male	159 (66.8)	79 (33.2)	1	1	1
Residence
Rural	86 (83.5)	17 (16.5)	2.3 (1.3–4.1)	2.4 (2.7–5.1)	0.03*
Urban	179 (68.8)	81 (31.2)	1	1	1
History of previous admission
Yes	178 (70.6)	74 (29.4)	0.7 (0.4–1.1)	0.6 (0.3–1.7)	0.25
No	87 (78.4)	24 (21.6)	1	1	1
Antihypertensive treatment before admission
No	81 (65.3)	43 (34.7)	0.9 (0.6–1.6)	0.5 (0.2–0.9)	0.02*
Yes	164 (68.6)	75 (31.4)	1	1	1
Treatment regimen before admission
Monotherapy	66 (52.4)	60 (47.6)	0.6 (0.3–0.9)	1.3 (0.7–1.8)	0.45
Combination therapy	75 (66.4)	38 (33.6)	1	1	1
Compliance to treatment
Yes	76 (51)	73 (49)	1	1	1
No	65 (72.2)	25 (27.8)	2.5 (1.2–3.2)	2.7 (1.4–3.5)	0.02*
Emergency drug administered during admission
Captopril	212 (83.1)	43 (16.9)	5.1 (2.2–6.3)	5.6 (2.4–7.9)	0.01*
Hydralazine	53 (49.0)	55 (50.9)	1	1	1

Note: *Statistically significant.

Abbreviations: COR, Crude Odd Ratio; AOD, Adjusted Odd Ratio.