Prevalence and Etiology of Early Return Visit (ERV) Within Three Days of Discharge in Emergency Department

Karim Bakhsh; Tamkeen Pervez; Muhammad Asad Sultan Khan; Sikandar Bakht Khan Mughal; Ahmed Tahir; Maria Khan

doi:10.51253/pafmj.v74i4.9755

Authors

Karim Bakhsh Department of Medicine, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Tamkeen Pervez Department of Medicine, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Muhammad Asad Sultan Khan Department of Spine Surgery, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Sikandar Bakht Khan Mughal Department of Emergency, Shifa International Hospital, Islamabad Pakistan
Ahmed Tahir Department of Emergency, Bahria International Hospital, Rawalpindi Pakistan
Maria Khan Department of Medicine, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i4.9755

Keywords:

Early return visit, Emergency room visits, Patient discharge.

Abstract

Objective: To determine the frequency and etiology of Early Return Visits within 3 days of discharge to the Emergency Department.

Study Design: Prospective longitudinal study.

Place and Duration of Study: Emergency Department of Combined Military Hospital, Rawalpindi Pakistan, from Jan to Jun 2022.

Methodology: All patients visiting the Emergency Department within the defined 6-month period were included in this study, which came to 101’113. To determine overall incidence of Early Return Visits, total number of patients revisiting within 72 hours of Emergency Department discharge was used. To find out the possible factors responsible for ERVs, a sample size of 80 patients revisiting the Emergency Department was calculated through World Health Organization calculator and selected through random sampling technique. Factors responsible for unscheduled Early Return Visits were divided into three broad categories: Doctor-associated, Disease-associated, and Patient-associated.

Results: The total number of patients revisiting Emergency Department within 72 hours was 2,880 (2.9%). Out of these 52.5% patients reported back to the Emergency Department due to disease-associated reasons, 27.5% due to doctor-related reasons, and 20% revisited for patient-related reasons.

Conclusion: Two-point nine percent patients made ERVs to the Emergency Department within 72 hours. The most common causes of Early Return Visits in this study are disease-related issues followed by doctor-related issues.

Downloads

Download data is not yet available.

References

unscheduled emergency department revisit within 72 hours of discharge. Cureus 2022; 14(4): e23975.

https://doi.org/10.7759/cureus.23975

Liu S-W. Risk factors of admission in 72-h return visits to emergency department. Tzu Chi Med. J 2021; 33(2): 169-174.

https://doi.org/10.4103/tcmj.tcmj_155_20

Ko M, Lee Y, Chen C, Chou P, Chu D. Incidence of and Predictors for Early Return Visits to the Emergency Department. Medicine 2015; 94(43): e1170.

https://doi.org/10.1097/MD.0000000000001770

Bilotienė–Motiejūnienė A, Klimašauskas A, Kontrimavičiūtė E, Janulevičienė R, Majauskytė D, Stukas R, et al. Unscheduled return visits to the emergency department: Incidence, reasons, possible solutions. Health Sci 2020; 30(1): 197-202.

https://doi.org/10.35988/sm-hs.2020.033

Alshahrani M, Katbi F, Bahamdan Y, Alsubaie A, Althawadi D. Frequency, Causes, and Outcomes of Return Visits to the Emergency Department Within 72 Hours: A Retrospective Observational Study. J Multidiscp Healthcare 2020; 13: 2003-2010.

https://doi.org/10.2147/jmdh.s282192

Hayward J, Hagtvedt R, Ma W, Gauri A, Vester M, Holroyd BR, et al. Predictors of Admission in Adult Unscheduled Return Visits to the Emergency Department. West J Emerg Med 2018; 19(6): 912-918. https://doi.org/10.5811/westjem.2018.8.38225

Burokienė S, Kairienė I, Strička M, Labanauskas L, Čerkauskienė R, Raistenskis J, et al. Unscheduled return visits to a pediatric emergency department. Medicina 2017; 53(1): 66–71.

https://doi.org/10.1016/j.medici.2017.01.003

Motiejuniene A, Klimasauskas A, Kontrimaviciute E, Jasiunas E, Januleviciene R, Majauskyte D, et al. Factors affecting return visits to the emergency department within 30 Days. Signa Vitae 2020; 17(1): 32–38. http://doi.org/10.22514/sv.2020.16.0080

Wang K-C, Chaou C-H, Liu P-H, Chien C-Y, Lee C-H. Factors affecting unscheduled return visits to the emergency department among Minor Head Injury patients. Biomed Res. Int 2017; 2017: 1–8. https://doi.org/10.1155/2017/8963102

Wu C-L, Wang F-T, Chiang Y-C, Chiu Y-F, Lin T-G, Fu L-F, et al. Unplanned Emergency Department revisits within 72 hours to a secondary teaching referral hospital in Taiwan. J Emerg Med 2010; 38(4): 512–517.

https://doi.org/10.1016/j.jemermed.2008.03.039

Tsai I-T, Sun C-K, Chang C-S, Lee K-H, Liang C-Y, Hsu C-W. Characteristics and outcomes of patients with emergency department revisits within 72 hours and subsequent admission to the Intensive Care Unit. Tzu Chi Med J 2016; 28(4): 151–156.

https://doi.org/10.1016/j.tcmj.2016.07.002

Shy BD, Loo GT, Lowry T, Kim EY, Hwang U, Richardson LD, et al. Bouncing Back Elsewhere: Multilevel analysis of return visits to the same or a different hospital after initial emergency department presentation. Ann Emerg Med 2018; 71: 555-563.

https://doi.org/10.1016/j.annemergmed.2017.08.023

Verelst S, Pierloot S, Desruelles D, Gillet J-B, Bergs J. Short-term Unscheduled Return Visits of Adult Patients to the Emergency Department. J Emerg Med 2014; 47(2): 131-139.

https://doi.org/10.1016/j.jemermed.2014.01.016

Hiti EA, Tamim H, Makki M, Geha M, Kaddoura R, Obermeyer Z. Characteristics and determinants of high-risk unscheduled return visits to the emergency department. Emerg Med J 2019; 37(2): 79-84. https://doi.org/10.1136/emermed-2018-208343

Sartini M, Carbone A, Dmartini A, Giribone L, Oliva M, Spagnolo AM, et al. Overcrowding in Emergency Department: Causes, Consequences, and Solutions-A Narrative Review. Healthcare 2022; 10(9): 1625.

https://doi.org/10.3390/healthcare10091625

Doan Q, Goldman RD, Meckler GD. Management practice-related and modifiable factors associated with paediatric emergency return visits. Paediatr Child Health 2018; 24(1): e1-7.

https://doi.org/10.1093/pch/pxy039

Yau F-FF, Yang Y, Cheng C-Y, Li C-J, Wang S-H, Chiu I-Min. Risk Factors for Early Return Visits to the Emergency Department in Patients Presenting with Nonspecific Abdominal Pain and the Use of Computed Tomography Scan. Healthcare 2021; 9(11): 1470. https://doi.org/10.3390/healthcare9111470

O’Loughlin K, Hacking KA, Simmons N, Christian W, Syahanee R, Shamekh A, et al. Paedriatic unplanned reattendance rate: A&E clinical quality indicators. Arch Dis Child 2013; 98(3): 211-213. https://doi.org/10.1136/archdischild-2012-302836