# Analyzing the Reasons and Hospital Admission Rates of 72‐Hour Emergency Department Revisits

## TL;DR

This study examines why patients return to the emergency department within 72 hours and finds that most revisits are due to disease progression rather than care quality.

## Contribution

The study identifies high-risk factors for non-discharge after revisits and emphasizes the need for targeted post-discharge support in emergency care.

## Key findings

- 96.5% of ED revisits were due to disease progression, not system or physician issues.
- Most patients (94%) were safely discharged after the second visit.
- High-risk factors include higher CTAS levels, dementia, and functional dependency.

## Abstract

Emergency department (ED) revisits are considered a significant indicator of the quality of care provided and are used as a benchmark for the performance of individual providers and institutions. The aim of this study is to assess ED revisit rates, reasons, and hospital admission rates among our adult ED patients.

This is a retrospective chart review study conducted in a single‐center tertiary referral hospital in Riyadh, Saudi Arabia. Study participants comprised adult patients who attended the ED, had been discharged, and had an ED revisit within 72 h from April 2019 to January 2020.

A total of 573 patients met our inclusion criteria, of whom 53.1% were males. The majority of the patients (74.5%) revisiting the ED were categorized as CTAS Level 3, with gastrointestinal complaints being the most common presentation for revisits (23.6%). During the second visit, 94%, 4%, 0.7%, and 0.3% of the participants were discharged, admitted, discharged against medical advice, and died, respectively. Disease progression was the most common cause of revisits at 96.5%. The factors that showed statistically significant associations with nondischarge disposition in the second visit were CTAS levels in the first and second visits, dementia, functional dependency, and reason for the revisit.

Most ED visits within 72 h are due to disease progression rather than system‐ or physician‐related issues, and the majority of these patients are safely discharged after the second visit. Identification of high‐risk patients—such as those with higher CTAS levels, dementia, or functional dependency—may aid emergency physicians in implementing targeted discharge planning and coordinated outpatient follow‐up to reduce unnecessary revisits and optimize use of emergency services. Our findings highlight the importance of structured post–discharge support and underscore the need for tailored interventions in resource‐limited healthcare settings.