Risk of repeat visits, hospitalisation and death after uncompleted and completed visits to the emergency department: a prospective observation study.

• Published in: Emergency Medicine Journal
• Main Authors: Geirsson, Oli Pall, Gunnarsdottir, Oddny Sigurborg, Baldursson, Jon, Hrafnkelsson, Birgir, Rafnsson, Vilhjalmur
• Other Authors: Department of Mathematics, University of Iceland, Reykjavik, Iceland 2Office of Education, Research and Development, the Landspitali, the National University Hospital, Reykjavik, Iceland 3Ministry of Welfare, Reykjavik, Iceland 4Department of Preventive Medicine, University of Iceland, Reykjavik, Iceland
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMJ Pub. Group 2013
• Subjects: Sjúklingar; Heilbrigðisþjónusta; Meðferð; Sjúkrahúsvist; Adult; Emergency Service; Hospital; Female; Humans; Iceland; Male; Middle Aged; Patient Readmission; Prospective Studies; Risk Factors; Treatment Refusal; Young Adult
• Online Access: http://hdl.handle.net/2336/313099; https://doi.org/10.1136/emermed-2012-201129

To access publisher's full text version of this article. Please click on the hyperlink in Additional Links field. 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. 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. 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. 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. Landspitali—the National University Hospital of Iceland research fund, Landspitali—the National University Hospital of Iceland