Prevalence And Outcomes Of Emergency Revisits Within 72 Hours of Discharge At Tertiary Care Center, Nepal

Abstract

Background: Emergency revisits within 72 hours of discharge serve as key indicators of healthcare quality and resource utilization. While global studies have explored various revisit timeframes, Nepal lacks comprehensive data on short-term ED revisits. This study aimed to determine the prevalence, causes, and outcomes of emergency revisits within 72 hours at a tertiary care hospital in Nepal.

Methods: A retrospective cross-sectional study was conducted at Tribhuvan University Teaching Hospital (TUTH), Nepal, analyzing 40,524 emergency visits over one year. 100 cases of revisits within 72 hours were identified. Patient demographics, triage categories, vital signs, and revisit outcomes were analyzed using MS Excel and RStudio. Ethical approval was obtained from the Institutional Review Committee (IRC), TUTH.

Results: The prevalence of emergency revisits was 0.247%, with a male predominance (60%). The highest revisit frequency was observed in the 50–60 years (22%) and 20–30 years (20%) age groups. There was a nearly five-fold increment in the number of red triage management as compared to index hospitalization which supports the reason for worsening of clinical presentation upon revisit. Common discharge diagnoses were pain in the abdomen (14%), acute febrile illness (13%), CKD (11%), and AE-COPD (10%). The primary revisit reasons were worsening symptoms (51%), no improvement (34%), and new symptoms (15%). 54% of revisiting patients required admission.

Conclusion: This study highlights the clinical and resource burden of emergency revisits in Nepal. A significant proportion of revisits resulted in inpatient admission, emphasizing the need for improved discharge planning and follow-up strategies.