Table 2.
Characteristics associated with unscheduled ED return: univariate and multivariate analysis
| |
Patients who did not return |
Patients with unscheduled return visits |
Unadjusted odds ratio
a,b
(95% CI),
P
value |
Adjusted odds ratio
a,b,c
(95% CI),
P
value |
|---|---|---|---|---|
| ( n = 41,750) | ( n = 2,161) | |||
| Age [mean (standard deviation)] |
38.2 (22.3) |
39.3 (20.7) |
1.00 (1.00, 1.00), 0.03 |
-e |
| Sex, male [n (%)] |
21,572 (51.7) |
1,155 (53.4) |
1.07 (0.99, 1.17), 0.11 |
- |
| Lacking health insurance [n (%)] |
1,714 (4.1) |
97 (4.5) |
1.01 (0.89, 1.35), 0.38 |
- |
| Lacking a GP [n (%)] |
3,255 (7.8) |
155 (7.2) |
0.91 (0.77, 1.08), 0.29 |
- |
| Triage level [n (%)] |
|
|
|
|
| Levels 1 and 2 |
6,482 (16.1) |
298 (14.2) |
1.00 (0.88, 1.15), 0.96 |
1.13 (0.97, 1.32), 0.12 |
| Level 3 |
13,324 (33.1) |
859 (41.0) |
1.41 (1.28, 1.55), <0.01 |
1.40 (1.26, 1.55), <0.01 |
| Levels 4 and 5 (reference category) |
20,428 (50.8) |
936 (44.7) |
1 |
1 |
| No triagec [n (%)] |
1,516 (3.6) |
68 (3.1) |
0.86 (0.67, 1.10), 0.24 |
- |
| Arrival time [n (%)] |
|
|
|
|
| Day, 7.30 a.m. to 3.29 p.m. (reference category) |
17,844 (42.7) |
882 (40.8) |
1 |
1 |
| Evening, 3.30 p.m. to 10.59 p.m. |
18,193 (43.6) |
925 (42.8) |
1.03 (0.94, 1.13), 0.56 |
1.03 (0.94, 1.14), 0.54 |
| Night, 11.00 p.m. to 7.29 a.m. |
5,713 (13.7) |
354 (16.4) |
1.25 (1.10, 1.42), <0.01 |
1.24 (1.09, 1.41), <0.01 |
| Length of stay [n (%)] |
|
|
|
|
| <1 h (reference category) |
9,918 (23.8) |
435 (20.1) |
1 |
- |
| 1 to 2 h |
11,966 (28.7) |
648 (30.0) |
1.24 (1.09, 1.40), <0.01 |
1.25 (1.09, 1.42), 0.00 |
| 2 to 3 h |
8,804 (21.1) |
452 (20.9) |
1.17 (1.02, 1.34), 0.02 |
1.16 (1.00, 1.34), 0.05 |
| 3 to 4 h |
5,001 (12.0) |
283 (13.1) |
1.29 (1.11, 1.50), <0.01 |
1.26 (1.06, 1.48), 0.01 |
| >4 h |
6,061 (14.5) |
343 (15.9) |
1.29 (1.12, 1.49), <0.01 |
1.24 (1.05, 1.45), 0.01 |
| Medical complaint [n (%)] |
|
|
|
|
| Extremity-related complaints |
9,789 (23.4) |
498 (23.0) |
0.98 (0.88, 1.08), 0.67 |
- |
| Wounds and local infections |
4,726 (11.3) |
281 (13.0) |
1.17 (1.03, 1.33), 0.02 |
1.34 (1.17, 1.54), <0.01 |
| Otherd |
4,480 (10.7) |
225 (10.4) |
0.97 (0.84, 1.11), 0.64 |
- |
| Abdominal pain |
3,597 (8.6) |
269 (12.4) |
1.51 (1.32, 1.72), <0.01 |
1.38 (1.20, 1.59), <0.01 |
| Chest pain |
3,547 (8.5) |
146 (6.8) |
0.78 (0.66, 0.93), <0.01 |
0.78 (0.64, 0.94), 0.01 |
| Feeling unwell |
3,124 (7.5) |
131 (6.1) |
0.80 (0.67, 0.96), <0.01 |
0.75 (0.62, 0.91), 0.00 |
| Eye/ear/nose problems and sore throat |
2,317 (5.5) |
107 (5.0) |
0.89 (0.73, 1.08), 0.24 |
- |
| Shortness of breath |
2,085 (5.0) |
99 (4.6) |
0.91 (0.74, 1.12), 0.39 |
- |
| Headache and head injury |
1,943 (4.5) |
98 (4.7) |
0.97 (0.79, 1.20), 0.80 |
- |
| Back pain |
826 (2.0) |
37 (1.7) |
0.86 (0.62, 1.20), 0.39 |
- |
| Trauma, severe |
771 (1.8) |
32 (1.5) |
0.80 (0.56, 1.14), 0.22 |
- |
| Psychiatric problem/substance abuse |
685 (1.6) |
44 (2.0) |
1.25 (0.92, 1.70), 0.16 |
- |
| Rashes |
660 (1.6) |
32 (1.5) |
0.94 (0.66, 1.34), 0.72 |
- |
| Urinary problems |
641 (1.5) |
59 (2.7) |
1.80 (1.37, 2.36), <0.01 |
1.72 (1.31, 2.26), <0.01 |
| Sick baby |
524 (1.3) |
12 (0.6) |
0.44 (0.25, 0.78), <0.01 |
0.47 (0.27, 0.84), 0.01 |
| No medical complaint registered | 2,035 (4.9) | 91 (4.2) | 0.86 (0.69, 1.06), 0.16 | - |
aCategorical variables (triage level, arrival time and categorized LOS) were entered as ‘dummy’ variables. bχ2 test, OR > 1 indicates an increased risk of unscheduled return. cAdjusted for included variables (age, triage level, arrival time, LOS, medical complaint) by logistic regression model, based on 42,327 observations (40,234 visits of patients who did not return and 2,093 unscheduled return visits) due to missing values on triage level (n = 1,584). dMedical complaints occurring less than 500 times per year (including allergy, dental problems, diabetes, exposure to chemicals, fits, neck pain, pregnancy, sexually acquired infections, testicular pain and vaginal bleeding) were categorized as ‘Other’. eNot in multivariable model.