Birthday Blues: Clinical Patterns of Emergency Department Visits Surrounding Birthdays

Smaller studies have suggested that patients are more likely to present to the emergency department around the time of their birthdays. However, no multi-year analysis has been performed within the U.S. to uncover a possible association between birthdays and presentation to the emergency department (ED).

The objective of this study was to evaluate the overall frequency year after year of visits to the Emergency Department and the medical conditions most frequently encountered around the time of a birthday.

We studied emergency department visits from May 2018 to May 2024 at a Level 1 Trauma Center in a metropolitan city in the U.S.. Our analysis assessed the interval before or after ED presentation with respect to a patient's birthday. We utilized timeframes of ± 7 days (7 d) of one's birthday, ± 14 days (14 d), and ± 30 days (30 d) for analysis. We then conducted a descriptive analysis comparing proportions, standardized ratios (SR), and obtaining predictive probabilities from a multivariate logistic regression model.

Of the 310,047 unique ED visits from 2018 to 2024, 12,650 visits were within ±7d of a patient's birthday. There were a greater than expected number of presentations ±7 d for all genders and age groups (particularly those <18 years old), and for those identifying as Asians. When looking at the role of chief complaint, individuals with a chief complaint related to Psychiatric/Toxicology, Trauma, Dermatologic, and Musculoskeletal concerns had a higher incidence of ED presentation ±7 d.

Across all populations, birthdays appear to be associated with an elevated risk of serious illness.