Emergency department revisits within 72 hours to a tertiary care referral hospital in South India

Introduction: Emergency department (ED) revisits are an important indication of health-care quality provided by a hospital. In the West, ED revisits rate range from 2.9% to 4.9%. However, data from India are lacking, and hence. this study was done. Methodology: This retrospective observational study was done in a 45-bedded ED of a teaching hospital in South India. All the patients who revisited the ED within 72 hours over a 1-year period were considered. The revisit was categorized as unavoidable if the patient was diagnosed correctly and managed appropriately during the first visit or if the patient presented with an unrelated illness within 72 hours. Results: The ED revisit rate was 0.8% (549/65,900). The monthly revisit rates ranged from 0.50% to 1.91%. About 57.9% were initially categorized as priority 3, 33.9% as priority 2, and 8.3% as priority 1 patients. During the revisit, 41.6% were priority 3 patients, 44.3% were priority 2 patients, and 13.7% were priority 1 patients. Gastrointestinal symptoms such as abdominal pain, vomiting, diarrhea, and constipation were the most common initial presenting complaints seen in 36% of the patients followed by fever (15.3%). A majority (75%) of these patients were initially discharged by the ED registrars. More than half (55.2%) of the revisits were avoidable. During the second visit, 58% were discharged in a stable condition, 31.7% were admitted to the hospital, and 4.8% died in the ED. Conclusion: ED revisits are associated with significant distress to the patients and more than half of them can be avoided.