Trauma patients returning to the emergency department after discharge

Emergency department return visits and hospital admissions in trauma team assessed patients initially discharged from the emergency department: A population-based cohort study

“…There is limited literature on the immediate short-term outcomes of discharged trauma patients, with most studies having focused on readmissions rather than outcomes in the subset of patients initially discharged from the ED. We found that 18% of our study population had at least one ED return visit within 2 weeks, which compares with the approximately 14% in previous studies 8,9,22 . However, considering that those studies used a 30-day follow-up period (compared with 14 days in our study), our rate of return visit is substantially higher.…”

“…We found that 18% of our study population had at least one ED return visit within 2 weeks, which compares with the approximately 14% in previous studies. 8,9,22 However, considering that those studies used a 30-day follow-up period (compared with 14 days in our study), our rate of return visit is substantially higher. An important contributor to this figure is that we were able to capture all return visits to all EDs across the province of Ontario, whereas most other studies were only able to capture return ED visits to the same hospital (or hospital group) because the patient visited on their index visit.…”

“…Wound care concerns have consistently been identified as a theme for return visits to the ED, with ED assessment and admission rates discrepant across studies. 8,[22][23][24][25] Many wound-related issues are more effectively managed in settings other than the ED including surgical clinics, family physician offices, or through home care services. Trauma programs should strive to provide routine wound care in these settings and to also advocate for better access to wound care services where local resources are limited.…”

Predictors of care discontinuity in geriatric trauma patients

“…Current databases do not collect patient reported outcome measures, which would provide a more wholesome assessment of care quality. We also must consider that most trauma patients who return to the Emergency Department after discharge are not readmitted, 33 and this was not captured in this study. Moreover, transfer status was not available for our population, and this may limit the generalizability of our results.…”

“…Finally, this is one of the few studies that evaluated reasons for readmissions and their role in care discontinuity. Shellito et al 33 found that the main reasons for trauma patients to return to the emergency department were pain management and wound complications. Olufajo et al 9 reported that musculoskeletal complaints were the most frequent reason for readmission after trauma.…”