The Value of Routine Blood Pressure Measurement in Children Presenting to the Emergency Department with Nonurgent Problems

被引:11
作者
Stewart, Jessica N.
McGillivray, David [1 ]
Sussman, John [1 ]
Foster, Bethany [2 ]
机构
[1] McGill Univ, Montreal Childrens Hosp, Div Emergency Med, Montreal, PQ H3H 1P3, Canada
[2] McGill Univ, Montreal Childrens Hosp, Dept Pediat Nephrol, Montreal, PQ H3H 1P3, Canada
关键词
D O I
10.1016/j.jpeds.2008.03.046
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objective Blood pressure (BP) is measured at triage in most emergency departments (EDs). We aimed to determine the value of triage BP in diagnosing hypotension and true hypertension in children age 2:3 years presenting with nonurgent problems. Study design In this prospective study. eligible children underwent automated BP measurement at triage. If BP was elevated. then the measurement was repeated manually. Children with a high manual BP were followed. True hypertension was defined as a manual BP >95th percentile for sex, age, and height measured on 3 occasions. Results Automated triage BP was measured in 549 children (53.4% male; mean age, 9.4 +/- 4.3 years) and was found to be elevated in 144 of them (26%). No child was hypotensive. Among the 495 patients with complete follows-up, the specific and positive predictive value (PPV) of elevated triage BP in diagnosing true hypertension were 81.8% and 0%, respectively. A sensitivity analysis including those with incomplete follow-up. in which the population prevalence of true hypertension was assumed to be 1% to 2%, resulted in a specificity of 74.5% to 75.3% and a PPV of 3.8% to 7.5%. Conclusions The yield of measuring BP at triage in children with noturgent problems appears to be extremely low.
引用
收藏
页码:478 / 483
页数:6
相关论文
共 14 条
[1]   Prevalence of hypertension in junior high school-aged children:: Effect of new recommendations in the 1996 updated task force report [J].
Adrogué, HE ;
Sinaiko, AR .
AMERICAN JOURNAL OF HYPERTENSION, 2001, 14 (05) :412-414
[2]  
[Anonymous], 2000, ADV DATA, V314, P1, DOI DOI 10.1186/1475-2875-6-146
[3]  
BEVERIDGE R, 1999, J EMERG MED S3, V1, pS2
[4]   Has blood pressure increased in children in response to the obesity epidemic? [J].
Chiolero, Arnaud ;
Bovet, Pascal ;
Paradis, Gilles ;
Paccaud, Fred .
PEDIATRICS, 2007, 119 (03) :544-553
[5]   Results of blood pressure screening in a population of school-aged children in the province of Milan: role of overweight [J].
Genovesi, S ;
Giussani, M ;
Pieruzzi, F ;
Vigorita, F ;
Arcovio, C ;
Cavuto, S ;
Stella, A .
JOURNAL OF HYPERTENSION, 2005, 23 (03) :493-497
[6]  
Natl High Blood Pressure Educ Prog, 2004, PEDIATRICS, V114, P555
[7]   Comparison of auscultatory and oscillometric blood pressures [J].
Park, MK ;
Menard, SW ;
Yuan, C .
ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE, 2001, 155 (01) :50-53
[8]   Inaccuracy in pediatric outpatient blood pressure measurement [J].
Podoll, Amber ;
Grenier, Michelle ;
Croix, Beth ;
Feig, Daniel I. .
PEDIATRICS, 2007, 119 (03) :E538-E543
[9]  
RALSTON H, 2006, PEDIAT ADV LIFE SUPP, P17
[10]   The frequency of blood pressure measurements in children in four EDs [J].
Silverman, MA ;
Walker, AR ;
Nicolaou, DD ;
Bono, MJ .
AMERICAN JOURNAL OF EMERGENCY MEDICINE, 2000, 18 (07) :784-788