ArticleThe western journal of emergency medicine2022
High-risk Return Visits to United States Emergency Departments, 2010-2018.
Article in The western journal of emergency medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Changing Presenting Complaints During 72-Hour Emergency Department Revisits: Associations with Functional Status and Revisit Outcomes.Healthcare (Basel, Switzerland) · 2026Article
- Multi-Evidence Clinical Reasoning With Retrieval-Augmented Generation for Emergency Triage: Retrospective Evaluation Study.JMIR medical informatics · 2026Article
- A Quality Improvement Initiative to Decrease Hospital Admission for Skin and Soft Tissue Infections From an Observation Unit.Journal of the American College of Emergency Physicians open · 2025Article
- Factors associated with overall and high-risk return visits to the emergency department: a vital sign trajectory approach.BMC emergency medicine · 2025Article
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAlthough 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.
methodsWe 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.
resultsOver 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.
conclusionHigh-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.
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