Cozzi Giorgio, Ghirardo Sergio, Fiorese Ilaria, Proietti Ilaria, Monasta Lorenzo, Minute Marta, Barbi Egidio, Calligaris Lorenzo
Emergency Department, Institute for Maternal and Child Health IRCCS 'Burlo Garofolo', Trieste, Italy.
University Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
J Paediatr Child Health. 2017 Sep;53(9):850-854. doi: 10.1111/jpc.13561. Epub 2017 May 17.
Early-revisits are frequent in the paediatric emergency department (ED) setting, but few data are available about early-revisited patients. The aim of this study was to investigate the hospitalisation rate of a population of early-revisited patients and to detect if an early-revisited patient was at risk of a more severe disease.
Between June 2014 and January 2015, we conducted a retrospective cohort study, considering all patients presented to the ED of a tertiary level children's hospital in Italy. We selected all patients who were revisited within 72 h from the initial visit (study cohort), while all other patients accessed in the same period were considered the control cohort. The two cohorts were compared for age, gender, triage category, hospitalisation rate, diagnosis at admission and hospital length of stay.
In the study period, we reviewed 10 750 visits, of which 430 (4%) were unplanned revisits for the same chief complaint within 72 h from the initial visit. Hospitalisation rate of early-revisited patients was significantly higher compared to control patients (8.4 vs. 2.9%). Hospitalisation rate increases in parallel with the number of revisits, but in many cases, it was not directly related to a worst triage category, neither to a longer hospital length of stay.
Early revisited patients in the ED had a significantly higher risk of hospitalisation, but this risk was only partially related to their clinical conditions.
在儿科急诊科，早期复诊很常见，但关于早期复诊患者的数据却很少。本研究的目的是调查早期复诊患者群体的住院率，并检测早期复诊患者是否有患更严重疾病的风险。
在2014年6月至2015年1月期间，我们进行了一项回顾性队列研究，纳入了意大利一家三级儿童医院急诊科的所有就诊患者。我们选取了所有在初次就诊后72小时内复诊的患者（研究队列），而同期就诊的所有其他患者被视为对照队列。比较了两个队列在年龄、性别、分诊类别、住院率、入院诊断和住院时长方面的情况。
在研究期间，我们审查了10750次就诊记录，其中430次（4%）是在初次就诊后72小时内因相同主诉进行的非计划复诊。早期复诊患者的住院率显著高于对照患者（8.4%对2.9%）。住院率随着复诊次数的增加而上升，但在许多情况下，这与更差的分诊类别无关，也与更长的住院时长无关。
急诊科的早期复诊患者住院风险显著更高，但这种风险仅部分与其临床状况相关。
