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Risk of repeat visits, hospitalisation and death after uncompleted and completed visits to the emergency department: a prospective observation study.
MedLine Citation:
PMID:  22983976     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: The needs of patients with uncompleted visits to the emergency department (ED) are uncertain. The aim was to evaluate ED patients who leave against medical advice (AMA) and who leave without being seen (WBS) regarding repeat ED visits, hospitalisation and mortality within 30 days. METHODS: The National University Hospital operates the only ED for adults in the capital area of Reykjavik. The source of data was the electronic records for patients 18 years or older, who left AMA, who left WBS, who had the ICD-10 code Z53.2, or who completed their visits. ED visits, hospital admissions and the death registry are filed with the personal identification number, which enabled recognition of the index visit, and the outcomes, rates of return visits, hospitalisation and death. RESULTS: Of 107 119 patients, 77 left AMA, 4471 left WBS and 423 had code Z53.2. The HR for returning to the ED within 30 days was 4.79 for AMA patients, 4.84 for WBS patients and 3.67 for Z53.2 patients. The HR for hospitalisation within 30 days was 6.90 for AMA patients, 1.09 for WBS patients and 1.07 for Z53.2 patients. The HR for death within 30 days was 10.97 for AMA patients, 0.84 for WBS and no deaths occurred among Z53.2 patients. DISCUSSION: During 30 days follow-up, AMA and WBS patients had an increased rate of repeat ED visits compared with those patients who completed their ED visits. AMA patients also had an increased rate of hospitalisations.
Authors:
Oli Pall Geirsson; Oddny Sigurborg Gunnarsdottir; Jon Baldursson; Birgir Hrafnkelsson; Vilhjalmur Rafnsson
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-14
Journal Detail:
Title:  Emergency medicine journal : EMJ     Volume:  -     ISSN:  1472-0213     ISO Abbreviation:  Emerg Med J     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100963089     Medline TA:  Emerg Med J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Mathematics, University of Iceland, Reykjavik, Iceland.
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