Unplanned return visit to emergency department: a descriptive study from a tertiary care hospital in a low-income...

Area of Science:

• Emergency Medicine
• Public Health
• Infectious Diseases

Background:

• Unplanned return visits to emergency departments (EDs) pose a significant challenge, particularly in low-income countries.
• Understanding the incidence, causes, and associated factors of these revisits is crucial for optimizing healthcare resource allocation and patient outcomes.

Purpose of the Study:

• To determine the incidence and causes of unplanned return visits to an ED within 48 hours.
• To identify factors associated with unplanned ED revisits requiring admission in a tertiary care center in a low-income country.

Main Methods:

• Retrospective chart review of all patients with unplanned ED revisits within 48 hours of their initial visit.
• Data analysis included calculating incidence rates and identifying risk factors using multivariable logistic regression.

Main Results:

• The incidence of unplanned ED revisits was 2%, with 69% of patients being adults.
• Fever was the most common presenting complaint (29%), and 55% of returning patients required admission.
• Independent risk factors for revisits requiring admission included fever, triage categories 1 and 2, and patients leaving against medical advice.

Conclusions:

• Infectious diseases are the primary driver of unplanned ED return visits in this low-income setting.
• Fever, severe triage categories, and patients leaving against medical advice are key indicators for revisits necessitating admission.
• These findings underscore the need for enhanced diagnostic and management strategies for infectious diseases in EDs within resource-limited environments.