Return visit rates after an emergency department discharge for children with sickle cell pain episodes. Pediatr Blood Cancer 2023 Oct;70(10):e30553
Date
07/17/2023Pubmed ID
37458568Pubmed Central ID
PMC11078470DOI
10.1002/pbc.30553Scopus ID
2-s2.0-85165245395 (requires institutional sign-in at Scopus site) 1 CitationAbstract
BACKGROUND: High return visit rates after hospitalization for people with sickle cell disease (SCD) have been previously established. Due to a lack of multicenter emergency department (ED) return visit rate data, the return visit rate following ED discharge for pediatric SCD pain treatment is currently unknown.
PROCEDURE: A seven-site retrospective cohort study of discharged ED visits for pain by children with SCD was conducted using the Pediatric Emergency Care Applied Research Network Registry. Visits between January 2017 and November 2021 were identified using previously validated criteria. The primary outcome was the 14-day return visit rate, with 3- and 7-day rates also calculated. Modified Poisson regression was used to analyze associations for age, sex, initial hospitalization rate, and a visit during the COVID-19 pandemic with return visit rates.
RESULTS: Of 2548 eligible ED visits, approximately 52% were patients less than 12 years old, 50% were female, and over 95% were non-Hispanic Black. The overall 14-day return visit rate was 29.1% (95% confidence interval [CI]: 27.4%-30.9%; site range 22.7%-31.7%); the 7- and 3-day return visit rates were 23.0% (95% CI: 21.3%-24.6%) and 16.7% (95% CI: 15.3%-18.2%), respectively. Younger children had slightly lower 14-day return visit rates (27.3% vs. 31.1%); there were no associations for site hospitalization rate, sex, and a visit occurring during the pandemic with 14-day returns.
CONCLUSION: Nearly 30% of ED discharged visits after SCD pain treatment had a return visit within 14 days. Increased efforts are needed to identify causes for high ED return visit rates and ensure optimal ED and post-ED care.
Author List
Coleman KD, McKinley K, Ellison AM, Alpern ER, Hariharan S, Topoz I, Wurtz M, Nielsen B, Cook LJ, Morris CR, Brandow AM, Campbell AD, Liem RI, Nuss R, Quinn CT, Thompson AA, Villella A, King AA, Baumann A, Frankenberger W, Brousseau DCAuthor
Keli D. Coleman MD Assistant Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Anemia, Sickle CellChild
Emergency Service, Hospital
Female
Humans
Male
Pain
Pandemics
Patient Discharge
Patient Readmission
Retrospective Studies
