EVALUATION OF THE CHARACTERISTICS OF REVISITS TO AN ADULT EMERGENCY DEPARTMENT WITHIN 72 HOURS

Nedim  Uzun; Ertuğrul  Altinbilek; M. Yaşar  Sever; Mustafa  Çalik

doi:10.33695/rojes.v2i1.19

Nedim Uzun Department of Emergency Medicine. University of Health Sciences, Gaziosmanpaşa Education and Research Hospital, Turkey
Ertuğrul Altinbilek Department of Emergency Medicine. University of Health Sciences, Şişli Etfal Education and Research Hospital, Turkey
M. Yaşar Sever Department of Emergency Medicine. University of Health Sciences, Gulhane Education and Research Hospital, Turkey
Mustafa Çalik Department of Emergency Medicine. University of Health Sciences, Gaziosmanpaşa Education and Research Hospital, Turkey

DOI: https://doi.org/10.33695/rojes.v2i1.19

Keywords: emergency department, revisit, triage, clinical outcome

Abstract

The objective of this study was to determine revisits of the patients discharged from the adult emergency department of our hospital in the early period (72 hours) between January 2016 and December 2016, and to evaluate characteristics of these revisits. In this study, records of the patients discharged from the adult emergency department in 2016 were retrospectively screened from the hospital information management system. Of the 361,413 patients, 7,800 (2.1%) met the inclusion criteria. The most common cause of the initial presentation was unexplained pain with 890 (11.4%) patients, while the most common diagnosis in revisits was acute upper respiratory tract infection with 642 (8.2%) patients. It was found that 18 patients (2.23%) died in the emergency department. No significant difference was found between triage scores of the emergency department presentations, while 161 patients with green area triage in the initial presentation presented to the red area and 134 of these patients were discharged. In our study, the revisit rate was similar with the studies in the literature. It was observed that the majority of the patients who revisited were discharged after the initial visit and they presented to the emergency department again upon their complaints continued. It was thought that revisits can be largely prevented with correct prescription and providing better information to patients.

References

[1] Schenkel S. Promoting patient safety and preventing medical error in emergency departments. Acad Emerg Med 2000; 7(11): 1204–1222.
[2] Van der Linden MC, Lindeboom R, de Haan R, van der Linden N, de Deckere ER, Lucas C, Rhemrev SJ, Goslings JC Unscheduled return visits to a Dutch inner-city emergency department. Int J Emerg Med. 2014 Jul 5;7:23.
[3] Sercan Bicakci, Nurcan Bicakci, Ali Duman, Ridvan Atilla Characteristics of recurrent emergency department visits within 72 hours of visits for the same or related complaints. Medicine Science İnternational Journal 9 May 2016.
[4] Siew Ling Loi, Mohd Hashairi Hj Fauzi and Abu Yazid Md Noh. Unscheduled early revisit to emergency department. Hong Kong Journal of Emergency Medicine 2018; 25(5):264-271.
[5] Han CY, Chen LC, Barnard A, et al. Early revisit to the emergency department: an integrative review. J Emerg Nurs 2015; 41(4): 285–295.
[6] Trivedy CR and Cooke MW. Unscheduled return visits (URV) in adults to the emergency department (ED): a rapid evidence assessment policy review. Emerg Med J 2015; 32(4): 324–329.
[7] Sri-On J, Nithimathachoke A. Revisits within 48 Hours to a Thai Emergency Department.Emerg Med Int. 2016;2016:8983573.
[8] J. Abualenain, W. J. Frohna, M. Smith et al., “The prevalence of quality issues and adverse outcomes among 72-hour return admissions in the emergency department,” The Journal of Emergency Medicine, vol. 45, no. 2, pp. 281–288, 2013.
[9] Barbadoro P, Di Tondo E, Menditto VG, Pennacchietti L, Regnicoli F, Di Stanislao F, D'Errico MM, Prospero E Emergency Department Non-Urgent Visits and Hospital Readmissions Are Associated with Different Socio-Economic Variables in Italy. Published online 2015 Jun 15;10(6):e0127823.
[10] Cossette S, Vadeboncoeur A, Frasure-Smith N, McCusker J, Perreault D, Guertin MC Randomized controlled trial of a nursing intervention to reduce emergency department revisits.CJEM.2015 Jan;17(1):13-20.
[11] Mahmoudi S, Taghipour HR, Javadzadeh HR, Ghane MR, Goodarzi H, Kalantar Motamedi MH Hospital Readmission Through the Emergency Department. Trauma Mon. 2016 Mar 1;21(2):e35139.
[12] Hocagil AC, Bildik F, Kılıçaslan İ, Hocagil H, Karabulut H, Keleş A2, Demircan A Evaluating Unscheduled Readmission to Emergency Department in the Early Period. Balkan Med J. 2016 Jan;33(1):72-9.
[13] Akyol C, Oktay C, Hakbilir O Acil Servise Aynı Şikayet ile Tekrar Başvuran Hastaların Değerlendirilmesi Turk J Emerg Med 2006;6(3):108-116.
[14] Verelst S, Pierloot S, Desruelles D, Gillet JB, Bergs J. Short-term unscheduled return visits of adult patients to the emergency department. J Emerg Med. 2014 Aug;47(2):131-9.
[15] Lerman B, Kobernick MS. Return visits to the emergency department. J Emerg Med 1987;5(5):359-62.
[16] Pierce JM, Kellerman AL, Bounces CO. An analysis of short-term return visits to a public hospital emergency department. Ann Emerg Med 1990;19(7):752-7.
[17] Wu CL, Wang FT, Chiang YC, Chiu YF, Lin TG, Fu LF, Tsai TL. Unplanned Emergency Department revisits within 72 hours to a secondary teaching referral hospital in Taiwan. J Emerg Med 2010;38(4):512-7.
[18] Abualenain J, Frohna WJ, Smith M, Pipkin M, Webb C, Milzman D, Pines JM. The prevalence of quality issues and adverse outcomes among 72-hour return admissions in the emergency department.J Emerg Med. 2013 Aug;45(2):281-8.
[19] Keith KD, Bocka JJ, Kobernick MS, Krome RL, Ross MA. Emergency department revisits. Ann Emerg Med 1989;18(9):964-8.
[20] Graf CE1, Giannelli SV, Herrmann FR, Sarasin FP, Michel JP, Zekry D, Chevalley T. Identification of older patients at risk of unplanned readmission after discharge from the emergency department - comparison of two screening tools. Swiss Med Wkly. 2012 Jan 3;141:w13327.
[21] https://www.saglik.gov.tr/Eklenti/1375,sagli k- turizmi-ve-turist-sagligi-kapsaminda-sunulac ak-saglik-hizmetleri-hakkinda-yonergedocx.doc x?0.
[22] Fabbian F, Boccafogli A, De Giorgi A, Pala M, Salmi R, Melandri R, Gallerani M, Gardini A, Rinaldi G, Manfredini R. The crucial factor of hospital readmissions: a retrospective cohort study of patients evaluated in the emergency department and admitted to the department of medicine of a general hospital in Italy. Eur J Med Res. 2015 Jan 27;20:6.