Analyzing the Reasons and Hospital Admission Rates of 72-Hour Emergency Department Revisits

Emergency department (ED) revisits are considered a significant indicator of the quality of care provided and are used as a benchmark for the performance of individual providers and institutions. The aim of this study is to assess ED revisit rates, reasons, and hospital admission rates among our adult ED patients.

This is a retrospective chart review study conducted in a single-center tertiary referral hospital in Riyadh, Saudi Arabia. Study participants comprised adult patients who attended the ED, had been discharged, and had an ED revisit within 72 h from April 2019 to January 2020.

A total of 573 patients met our inclusion criteria, of whom 53.1% were males. The majority of the patients (74.5%) revisiting the ED were categorized as CTAS Level 3, with gastrointestinal complaints being the most common presentation for revisits (23.6%). During the second visit, 94%, 4%, 0.7%, and 0.3% of the participants were discharged, admitted, discharged against medical advice, and died, respectively. Disease progression was the most common cause of revisits at 96.5%. The factors that showed statistically significant associations with nondischarge disposition in the second visit were CTAS levels in the first and second visits, dementia, functional dependency, and reason for the revisit.

Most ED visits within 72 h are due to disease progression rather than system- or physician-related issues, and the majority of these patients are safely discharged after the second visit. Identification of high-risk patients-such as those with higher CTAS levels, dementia, or functional dependency-may aid emergency physicians in implementing targeted discharge planning and coordinated outpatient follow-up to reduce unnecessary revisits and optimize use of emergency services. Our findings highlight the importance of structured post-discharge support and underscore the need for tailored interventions in resource-limited healthcare settings.