Examination of re-admission and causes with pain patients in the emergency department

Abstract

Objective: Pain is an essential symptom in emergency department admissions, but few studies have focused on its effect. This study aimed to determine the admission rates of patients with a pain diagnosis and to evaluate the rate of re-admissions to the emergency service within one month. Also, this patient group will determine the reasons for returning to the emergency department by examining the emergency service data of the only hospital in the city centre and the largest in the province. Material and Methods: In this study, patients who presented to the emergency department with a complaint of musculoskeletal pain between January 1 and December 31, 2021, and entered the R52, M25, M54, and M79 ICD codes (and their subgroups) as a diagnosis into the system were selected. Patients were classified as traumatic/non-traumatic (patients who requested extremity radiography or tomography were considered traumatic). The files were retrospectively scanned to determine the treatments administered to specific patients in the emergency department. It was investigated whether these patients subsequently sought treatment in the relevant branches, such as neurosurgery, orthopedics, or physical medicine and rehabilitation outpatient clinics, within one month. Furthermore, the patients' re-admission to the emergency service within one month were examined. Results: A total of 1742 patient files were included in the study. 50.8% of the patients were male, and the mean age was 41.9±17.3. It was determined that 1407 patients (80.8%) were treated in the emergency department, and the highest rate (61.2%) was intramuscular (IM) injection. The rate of going to the outpatient clinic was 17.6%, and the mean time of being examined was 2±5.4 days. It was observed that 30.4% of the patients were admitted to the emergency department again. The patients were divided into two groups according to whether they had a history of trauma or not. The ratio of male patients was higher in both groups (p>0.05), and the mean age of patients with trauma was lower (35±18.6). The rate of re-admission to the emergency department of the patients without trauma was significantly higher than the other group (p<0.05). The rate of being examined in the relevant polyclinic was higher in the group without trauma (17.8%). Conclusion: This study found a high admission rate to the emergency department for patients presenting with pain complaints. Furthermore, there was a notable high re-admission rate among patients without trauma following outpatient clinic examinations. It is evident that achieving effective pain control for these patients may require a significant amount of time. The recurrent emergency admissions may be attributed to persistent pain complaints