泌尿部住院病人出院後72小時內重返急診因素分析
陳安貞, 王首文, 鄭鴻琳, 歐建慧, 林永明
國立成功大學醫學院附設醫院 泌尿部
Patients discharged from urologic ward return to
emergency department in 72 hours: The clinical features
An-Chen Chen1,2 , Shou-Wen Wang2, Hong-Lin Cheng1, Chien-Hui Ou1, Yung-Ming Lin1
Department of Urology1, Department of Nursing2,
National Cheng Kung University Hospital, College of Medicine,
National Cheng Kung University, Tainan, Taiwan
Purpose: It is an important issue about immediate emergency department return after discharge from
ward. It not only costs massive social resources, but also distracts patient, family, and doctors and nurses.
Besides, potential medical problem may exist in those patients, and it may affect satisfaction of treatment.
Reviewing those cases to figure out the cause of emergency department return may improve the quality ofmedical care.
Material and methods: This retrospective study included patients who were discharged from urologic
ward in NCKU hospital, and returned to our emergency department in 72 hours between 2015/01/01-
2015/12/31. We reviewed medical records during admission and emergency department including further management and clinical course. In 2015, in our hospital, the patients number of discharge from our
hospital is 52027, and retuning to emergency department in 72 hours of entire hospital is 1287(2.5%).
However, the number of discharge from urologic ward is 2021, and 67 visits (3.3%) of emergency
department return is recorded, and it is higher than the average of our hospital.
Results: Among 67 emergency department visits, most patients came back to emergency department
during the first two days. 25 visits (37.3%) are within in the first 24 hours, and during second 24 hours,
24 visits (35.8%) are recorded. 42 visits are old age (more than 65-year-old), and 61 visits are male.
3 patients came back to emergency department repeatedly. The most common cause of emergency
department is acute urine retention (28.4%). The second one is bleeding including gross hematuria
(17.9%). Further management including medication(43.3%), invasive intervention(55.2%) ,
admission(urologic department or other departments) or surgery(1.5%) are also collected in this study.
Conclusion: Reviewing those immediate emergency department return after discharge from urologic
ward may be helpful for medical quality improvement. Further health education and evaluation material
before discharge can be developed based on the results of this study.