Age-Related Differences in 30-Day Outcomes Following Emergency Department Discharge For Hypertension

Document Type

Conference Proceeding

Publication Date

10-2026

Publication Title

Annals of Emergency Medicine

Abstract

Objectives: Discharging emergency department (ED) patients with elevated blood pressure is generally safe, but it is unclear whether increasing age is associated with worse short-term outcomes following ED discharge for hypertension. Our primary objective was to evaluate the association between patient age and adverse events within 30 days following ED discharge for hypertension. Secondary objectives included assessing the association between patient age and return visits to the ED within 30 days of discharge and the association between patient age and patient death following ED discharge within 30 days. Methods: We conducted a retrospective observational cohort Study using electronic health record data from a large, multi-center health system in southeast Michigan. Adult patients (≥18 years) discharged from the ED with a diagnosis of hypertension between January 2016 and February 2020 were included. Patients with prior antihypertensive treatment within 18 months, hospital admission, pregnancy, or missing key demographic data were excluded. The primary outcome was a composite of 30-day adverse events (including acute heart failure, myocardial infarction, stroke, aortic catastrophe, and hypertensive encephalopathy). Secondary outcomes included 30-day all-cause mortality and ED revisit. Age was analyzed as a categorical variable (18-49, 50-64, 65-79, ≥80 years). Multivariable logistic regression was used to evaluate the association between age group and outcomes, adjusting for gender, race, antihypertensive prescription at discharge, and comorbidity burden (Elixhauser Comorbidity Index). Adjusted odds ratios (aORs) with 95% confidence intervals were reported, with statistical significance defined as p < 0.05. Results: A total of 93,512 patients were included during this Study period. Overall, the 30-day adverse event rate was 0.7%, with patients aged ≥80 years demonstrating the highest observed adverse event rate at 1.7%. After adjustment for gender, race, antihypertensive prescription, and comorbidity burden, patients aged ≥80 years had significantly increased odds of experiencing a 30-day adverse event compared with patients aged 18-49 years (aOR 5.20, 95% CI 3.95 – 6.83, p< 0.001). Patients aged ≥80 years also had significantly higher odds of 30-day mortality (aOR 17.7, 95% CI 8.00 – 47.08, p< 0.001). Acute heart failure was the only individual adverse event significantly associated with older age and was the primary contributor to the composite adverse event outcome. Hypertensive encephalopathy was not significantly associated with age. Younger patients demonstrated higher rates of 30-day revisits compared with older patients (p< 0.001). Conclusion: Advanced age was strongly associated with worse short-term outcomes following ED discharge for hypertension, with patients aged ≥80 years demonstrating significantly higher risks of both adverse events and death which stresses the importance of exercising caution when discharging elderly patients with hypertension medication. Younger patients had higher rates of 30-day ED return visits, suggesting differing post-discharge utilization patterns across age groups. These findings support increased caution, closer follow-up, and individualized discharge planning for elderly patients presenting with hypertension in the emergency department.

Volume

88

Issue

4 Suppl 1

First Page

S228

Comments

American College of Emergency Physicians (ACEP) Research Forum, October 5-7, 2026, Chicago, IL

Last Page

S229

DOI

10.1016/j.annemergmed.2026.08.511

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