Deep learning to predict emergency department revisit using static and dynamic features (Deep Revisit): development and validation study.

backgroundEmergency Department (ED) revisits represent a critical issue in emergency medicine. Identifying high-risk revisit cases (revisits with intensive care unit admissions, cardiac arrest, or requiring emergency surgery) is particularly important. While prior studies have explored machine learning models for ED revisit prediction, few deep learning approaches exist, and dynamic features remain underutilized.

methodsWe used data from National Taiwan University Hospital (NTUH), incorporating both static (e.g., age, sex, triage) and dynamic (vital signs) features. A preprocessing strategy was developed to handle temporal irregularities. We proposed a hybrid deep learning model combining Temporal Convolutional Network (TCN) and feature tokenizer (FT)-Transformer to integrate static and short-term dynamic information.

resultsWe evaluated our model on NTUH 2016-2019 data, achieving the area under the receiver operating characteristic curve (AUROC) of 0.8453 and the area under precision recall curve (AUPRC) of 0.0935 for high-risk revisits (base rate = 0.01), and AUROC of 0.7250 and AUPRC of 0.2005 for general revisits (base rate = 0.042). The model maintained robust performance when validated on 2020-2022 data. Compared to the static-only logistic regression baseline, our model improved AUPRC from 0.0288 to 0.0935 and precision from 0.0281 to 0.0428.

conclusionOur model significantly outperformed the static-only baseline. It demonstrates the effectiveness of multimodal clinical data fusion in improving ED revisit prediction and supporting clinical decision-making.