Pain Associated With Increased Frequency of ED Revisits

According to a presentation at the AAPM 2018 Annual Meeting, pain is associated with an increase in emergency department (ED) revisits.

“Pain accounts for up to 78% of all ED visits,” Sophia S Sheikh, MD, assistant professor in the department of emergency medicine at the University of Florida College of Medicine, and colleagues wrote. “Annually, 16% to 22% of all-cause ED visits result in a return visit within 30 days; 14% to 20% of returns will be hospitalized. The impact of pain on ED return visits is unknown.”

To measure how pain impacts ED revisits, the researchers conducted a study including 389 adult patients who presented within 30 days of an ED visit or hospital discharge. They calculated the minimum clinically significant difference in pain scores and measured for determining predictors of ED revisits for pain.

Study results showed that 66% of the study cohort returned to the ED for pain-related reasons. The researchers found minimum clinically significant difference in 56% of patients who returned to the ED for pain. 

Factors associated with return visits for pain did not include opioid use, the researchers noted. They found that patients with low REALM Health Literacy scores, increased acuity, gastrointestinal complaints, and circulatory complaints, were predictors of return vists related to pain.

“Pain greatly contributed to ED return visits,” the researchers concluded. “Predictive factors of ED return visits for pain may inform prevention strategies.” —David Costill