急诊科
医学
急诊分诊台
生命体征
预警得分
急诊医学
入射(几何)
外科
精神科
光学
物理
作者
Chih-Wei Sung,Tsung-Chien Lu,Cheng-Chung Fang,Jia-You Lin,Huang-Fu Yeh,Chien-Hua Huang,Chu-Lin Tsai
出处
期刊:European Journal of Emergency Medicine
[Ovid Technologies (Wolters Kluwer)]
日期:2021-06-29
卷期号:28 (5): 394-401
被引量:6
标识
DOI:10.1097/mej.0000000000000851
摘要
Although factors related to a return emergency department (ED) visit have been reported, few studies have examined 'high-risk' return ED visits with serious adverse outcomes. Understanding factors associated with high-risk return ED visits may help with early recognition and prevention of these catastrophic events.We aimed to (1) estimate the incidence of high-risk return ED visits, and (2) to investigate time-varying factors associated with these revisits.Case-crossover study.We used electronic clinical warehouse data from a tertiary medical center. We retrieved data from 651 815 ED visits over a 6-year period. Patient demographics and computerized triage information were extracted.A high-risk return ED visit was defined as a revisit within 72 h of the index visit with ICU admission, receiving emergency surgery, or with in-hospital cardiac arrest during the return ED visit. Time-varying factors associated with a return visit were identified.There were 440 281 adult index visits, of which 19 675 (4.5%) return visits occurred within 72 h. Of them, 417 (0.1%) were high-risk revisits. Multivariable analysis showed that time-varying factors associated with an increased risk of high-risk revisits included the following: arrival by ambulance, dyspnea, or chest pain on ED presentation, triage level 1 or 2, acute change in levels of consciousness, tachycardia (>90/min), and high fever (>39°C).We found a relatively small fraction of discharges (0.1%) developed serious adverse events during the return ED visits. We identified symptom-based and vital sign-based warning signs that may be used for patient self-monitoring at home, as well as new-onset signs during the return visit to alert healthcare providers for timely management of these high-risk revisits.
科研通智能强力驱动
Strongly Powered by AbleSci AI