ArticleEmergency medicine journal : EMJ2020
Characteristics and determinants of high-risk unscheduled return visits to the emergency department.
Article in Emergency medicine journal : EMJ, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Evaluation of a Generative Medical Event Foundation Model for Predicting Post-Discharge Trajectories in Emergency Department Abdominal Pain.medRxiv : the preprint server for health sciences · 2026Article
- Article
- Changing Presenting Complaints During 72-Hour Emergency Department Revisits: Associations with Functional Status and Revisit Outcomes.Healthcare (Basel, Switzerland) · 2026Article
- A real-world feasibility evaluation of LLM-based clinical prediction: emergency department return visit admission across two academic medical centers.Research square · 2026Article
- Outcomes of 72-hour emergency department return visits requiring hospital admission in older adults: a nationally representative analysis.BMC geriatrics · 2026Article
- Observational
- Telehealth Emergency Department Transition-of-care Program: A Value-based Innovation.The western journal of emergency medicine · 2025Article
- Factors associated with overall and high-risk return visits to the emergency department: a vital sign trajectory approach.BMC emergency medicine · 2025Article
- Performance comparison of artificial intelligence models in predicting 72-h emergency department unscheduled return visits.Frontiers in public health · 2025Article
- Aspiring to clinical significance: Insights from developing and evaluating a machine learning model to predict emergency department return visit admissions.PLOS digital health · 2024Article
- Prediction of high-risk emergency department revisits from a machine-learning algorithm: a proof-of-concept study.BMJ health & care informatics · 2024Article
- High-risk Return Visits to United States Emergency Departments, 2010-2018.The western journal of emergency medicine · 2022Article
- Inpatient Outcomes Following a Return Visit to the Emergency Department: A Nationwide Cohort Study.The western journal of emergency medicine · 2021Article
- Discharge in Pandemic: Suspected Covid-19 patients returning to the Emergency Department within 72 hours for admission.The American journal of emergency medicine · 2021Article
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Authors and funding
6 authors.
Funding
Abstract
backgroundHigh-risk unscheduled return visits (HRURVs), defined as return visits within 72 hours that require admission or die in the emergency department (ED) on representation, are a key quality metric in the ED. The objective of this study was to determine the incidence and describe the characteristics and predictors of HRURVs to the ED.
methodsCase-control study, conducted between 1 November 2014 and 31 October 2015. Cases included all HRURVs over the age of 18 that presented to the ED. Controls were selected from patients who were discharged from the ED during the study period and did not return in the next 72 hours. Controls were matched to cases based on gender, age (±5 years) and date of presentation.
resultsOut of 38 886 ED visits during the study period, 271 are HRURVs, giving an incidence of HRURV of 0.70% (95% CI 0.62% to 0.78%). Our final analysis includes 270 HRURV cases and 270 controls, with an in-ED mortality rate of 0.7%, intensive care unit admission of 11.1% and need for surgical intervention of 22.2%. After adjusting for other factors, HRURV cases are more likely to be discharged with a diagnosis related to digestive system or infectious disease (OR 1.64, 95% CI 1.02 to 2.65 and OR 2.81, 95% CI 1.05 to 7.51, respectively). Furthermore, presentation to the ED during off-hours is a significant predictor of HRURV (OR 1.64, 95% CI 1.11 to 2.43) as is the presence of a handover during the patient visit (OR 1.68, 95% CI 1.02 to 2.75).
conclusionHRURV is an important key quality outcome metric that reflects a subgroup of ED patients with specific characteristics and predictors. Efforts to reduce this HRURV rate should focus on interventions targeting patients discharged with digestive system, kidney and urinary tract and infectious diseases diagnosis as well as exploring the role of handover tools in reducing HRURVs.
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