4.2 Article

High-risk Return Visits to United States Emergency Departments, 2010-2018

期刊

WESTERN JOURNAL OF EMERGENCY MEDICINE
卷 23, 期 6, 页码 832-840

出版社

WESTJEM
DOI: 10.5811/westjem.2022.7.57028

关键词

-

资金

  1. Ministry of Science and Technology [111-2634-F-002-015, 111-2314-B-002-264]
  2. National Taiwan University Hospital [111-CGN-0005]

向作者/读者索取更多资源

This study aimed to investigate the incidence, trend, and factors associated with high-risk emergency department (ED) revisits. High-risk revisits accounted for a stable proportion of ED visits over the study period. Older age, Hispanic ethnicity, daytime visits, and arrival by ambulance were independent predictors of high-risk revisits.
Introduction: Although factors related to a return visit to the emergency department (ED) have been reported, only a few studies have examined high-risk ED revisits with serious adverse outcomes. In this study we aimed to describe the incidence and trend of high-risk ED revisits in United States EDs and to investigate factors associated with these revisits.Methods: We obtained data from the National Hospital Ambulatory Medical Care Survey (NHAMCS), 2010-2018. Adult ED revisits within 72 hours of a previous discharge were identified using a mark on the patient record form. We defined high-risk revisits as revisits with serious adverse outcomes, including intensive care unit admissions, emergency surgery, cardiac catheterization, or cardiopulmonary resuscitation (CPR) during the return visit. We performed analyses using descriptive statistics and multivariable logistic regression, accounting for NHAMCS's complex survey design.Results: Over the nine-year study period, there were an estimated 37,700,000 revisits, and the proportion of revisits in the entire ED population decreased slightly from 5.1% in 2010 to 4.5% in 2018 (P for trend = 0.02). By contrast, there were an estimated 827,000 high-risk ED revisits, and the proportion of high-risk revisits in the entire ED population remained stable at approximately 0.1%. The mean age of these high-risk revisit patients was 57 years, and 43% were men. Approximately 6% of the patients were intubated, and 13% received CPR. Most of them were hospitalized, and 2% died in the ED. Multivariable analysis showed that older age (65+ years), Hispanic ethnicity, daytime visits, and arrival by ambulance during the revisit were independent predictors of high-risk revisits.Conclusion: High-risk revisits accounted for a relatively small fraction (0.1%) of ED visits. Over the period of the NHAMCS survey between 2010-2018, this fraction remained stable. We identified factors during the return visit that could be used to label high-risk revisits for timely intervention. [West J Emerg Med. 2022;23(6)832-840.]

作者

我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。

评论

主要评分

4.2
评分不足

次要评分

新颖性
-
重要性
-
科学严谨性
-
评价这篇论文

推荐

暂无数据
暂无数据