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The risk factors of the 72-h unscheduled return visit admission to emergency department in adults below 50 years old
BACKGROUND: An unscheduled return visit (URV) to the emergency department (ED) within 72-h is an indicator of ED performance. An unscheduled return revisit (URV) within 72-h was used to monitor adverse events and medical errors in a hospital quality improvement program. The study explores the potent...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10523721/ https://www.ncbi.nlm.nih.gov/pubmed/37759319 http://dx.doi.org/10.1186/s40001-023-01317-x |
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author | Kao, Chia-Lung Chuang, Chia-Chang Hwang, Chi-Yuan Lee, Chung-Hsun Huang, Po-Chang Hong, Ming-Yuan Chi, Chih-Hsien |
author_facet | Kao, Chia-Lung Chuang, Chia-Chang Hwang, Chi-Yuan Lee, Chung-Hsun Huang, Po-Chang Hong, Ming-Yuan Chi, Chih-Hsien |
author_sort | Kao, Chia-Lung |
collection | PubMed |
description | BACKGROUND: An unscheduled return visit (URV) to the emergency department (ED) within 72-h is an indicator of ED performance. An unscheduled return revisit (URV) within 72-h was used to monitor adverse events and medical errors in a hospital quality improvement program. The study explores the potential factors that contribute to URV to the ED within 72-h and the unscheduled return revisit admission (URVA) in adults below 50 years old. METHODS: The case–control study enrolled 9483 URV patients during 2015–2020 in National Cheng-Kung University Hospital. URVA and URV non-admission (URVNA) patients were analyzed. The Gini impurity index was calculated by decision tree (DT) to split the variables capable of partitioning the groups into URVA and URVNA. Logistic regression is applied to calculate the odds ratio (OR) of candidate variables. The α level was set at 0.05. RESULTS: Among patients under the age of 50, the percentage of females in URVNA was 55.05%, while in URVA it was 53.25%. Furthermore, the average age of URVA patients was 38.20 ± 8.10, which is higher than the average age of 35.19 ± 8.65 observed in URVNA. The Charlson Comorbidity Index (CCI) of the URVA patients (1.59 ± 1.00) was significantly higher than that of the URVNA patients (1.22 ± 0.64). The diastolic blood pressure (DBP) of the URVA patients was 85.29 ± 16.22, which was lower than that of the URVNA (82.89 ± 17.29). Severe triage of URVA patients is 21.1%, which is higher than the 9.7% of URVNA patients. The decision tree suggests that the factors associated with URVA are “severe triage,” “CCI higher than 2,” “DBP less than 86.5 mmHg,” and “age older than 34 years”. These risk factors were verified by logistic regression and the OR of CCI was 2.42 (1.50–3.90), the OR of age was 1.84 (1.50–2.27), the OR of DBP less than 86.5 was 0.71 (0.58–0.86), and the OR of severe triage was 2.35 (1.83–3.03). CONCLUSIONS: The results provide physicians with a reference for discharging patients and could help ED physicians reduce the cognitive burden associated with the diagnostic errors and stress. |
format | Online Article Text |
id | pubmed-10523721 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-105237212023-09-28 The risk factors of the 72-h unscheduled return visit admission to emergency department in adults below 50 years old Kao, Chia-Lung Chuang, Chia-Chang Hwang, Chi-Yuan Lee, Chung-Hsun Huang, Po-Chang Hong, Ming-Yuan Chi, Chih-Hsien Eur J Med Res Research BACKGROUND: An unscheduled return visit (URV) to the emergency department (ED) within 72-h is an indicator of ED performance. An unscheduled return revisit (URV) within 72-h was used to monitor adverse events and medical errors in a hospital quality improvement program. The study explores the potential factors that contribute to URV to the ED within 72-h and the unscheduled return revisit admission (URVA) in adults below 50 years old. METHODS: The case–control study enrolled 9483 URV patients during 2015–2020 in National Cheng-Kung University Hospital. URVA and URV non-admission (URVNA) patients were analyzed. The Gini impurity index was calculated by decision tree (DT) to split the variables capable of partitioning the groups into URVA and URVNA. Logistic regression is applied to calculate the odds ratio (OR) of candidate variables. The α level was set at 0.05. RESULTS: Among patients under the age of 50, the percentage of females in URVNA was 55.05%, while in URVA it was 53.25%. Furthermore, the average age of URVA patients was 38.20 ± 8.10, which is higher than the average age of 35.19 ± 8.65 observed in URVNA. The Charlson Comorbidity Index (CCI) of the URVA patients (1.59 ± 1.00) was significantly higher than that of the URVNA patients (1.22 ± 0.64). The diastolic blood pressure (DBP) of the URVA patients was 85.29 ± 16.22, which was lower than that of the URVNA (82.89 ± 17.29). Severe triage of URVA patients is 21.1%, which is higher than the 9.7% of URVNA patients. The decision tree suggests that the factors associated with URVA are “severe triage,” “CCI higher than 2,” “DBP less than 86.5 mmHg,” and “age older than 34 years”. These risk factors were verified by logistic regression and the OR of CCI was 2.42 (1.50–3.90), the OR of age was 1.84 (1.50–2.27), the OR of DBP less than 86.5 was 0.71 (0.58–0.86), and the OR of severe triage was 2.35 (1.83–3.03). CONCLUSIONS: The results provide physicians with a reference for discharging patients and could help ED physicians reduce the cognitive burden associated with the diagnostic errors and stress. BioMed Central 2023-09-27 /pmc/articles/PMC10523721/ /pubmed/37759319 http://dx.doi.org/10.1186/s40001-023-01317-x Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Kao, Chia-Lung Chuang, Chia-Chang Hwang, Chi-Yuan Lee, Chung-Hsun Huang, Po-Chang Hong, Ming-Yuan Chi, Chih-Hsien The risk factors of the 72-h unscheduled return visit admission to emergency department in adults below 50 years old |
title | The risk factors of the 72-h unscheduled return visit admission to emergency department in adults below 50 years old |
title_full | The risk factors of the 72-h unscheduled return visit admission to emergency department in adults below 50 years old |
title_fullStr | The risk factors of the 72-h unscheduled return visit admission to emergency department in adults below 50 years old |
title_full_unstemmed | The risk factors of the 72-h unscheduled return visit admission to emergency department in adults below 50 years old |
title_short | The risk factors of the 72-h unscheduled return visit admission to emergency department in adults below 50 years old |
title_sort | risk factors of the 72-h unscheduled return visit admission to emergency department in adults below 50 years old |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10523721/ https://www.ncbi.nlm.nih.gov/pubmed/37759319 http://dx.doi.org/10.1186/s40001-023-01317-x |
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