Mortality and in-patient outcomes in pheochromocytoma patients with hypertensive emergency in the United States: A propensity score matched analysis

Hypertensive emergency represents a critical medical condition characterized by severe hypertension leading to organ damage, including myocardial infarction, pulmonary edema, stroke, and acute kidney injury. This condition, though rare with an estimated incidence of 0.5% among emergency department (ED) visits, carries a significant mortality risk—ranging from 5–13% during hospitalization to 26–39% within the first 30 days post-presentation.1,2 Recent epidemiological data indicate a rising trend in hypertensive emergency presentations, with ED visits doubling from 2006 to 2013.2

Pheochromocytoma, a rare tumor causing hypertension, has an incidence rate of approximately 0.6 cases per 100,000 person-years and represents a mere 0.1% of all hypertension cases in the United States.3,4 Distinguishing pheochromocytoma from other causes of hypertensive emergencies is critical due to its unique management approach. Unlike the general treatment of hypertensive emergencies, which involves titrating antihypertensive medications and transitioning to more potent oral regimens, pheochromocytoma requires surgical intervention to remove the catecholamine-secreting tumor, often resulting in a curative outcome.5, 6, 7, 8, 9

Despite the clear differentiation in treatment approaches between hypertensive emergencies caused by pheochromocytoma and other etiologies, there is a scarcity of high-quality data directly comparing inpatient outcomes of these two patient populations. Addressing this gap, our study leverages the National Inpatient Sample (NIS) database to explore the clinical characteristics and inpatient outcomes of patients admitted with hypertensive emergencies, including those diagnosed with pheochromocytoma. A secondary objective of our study is to assess the impact of pheochromocytoma on the outcomes of patients admitted for hypertensive emergencies.

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