Keywords
Return Visits
72-hour Revisit
Karachi
Pakistan
Gastrointestinal Illness
Respiratory Illness
How to Cite
Abstract
Background
Unscheduled 72-hour return visits to the pediatric emergency department (ED) serve as a vital indicator of healthcare quality and discharge effectiveness. In resource-limited settings like Pakistan, factors such as overcrowding and limited access to primary care may increase these revisits. However, data regarding the specific determinants of early return visits in this region remain scarce.
Objective
To determine the frequency and factors contributing to 72-hour return visits among pediatric patients at a tertiary care hospital emergency department in Karachi, Pakistan.
Methods
This retrospective observational study was conducted at a free, urban, tertiary-care teaching hospital in Karachi. The study analyzed 1,541 pediatric patients aged 0–14 years who had an unscheduled return visit within 72 hours of discharge during the year 2019. Data were extracted from the hospital’s Health Management Information System and analyzed using descriptive and inferential statistics via SPSS.
Results
Of the 1,541 patients, 58.1% were male and 98% were local residents of Karachi. Revisits were most frequent among younger children, with 51.7% aged 1 day to 2 years. Gastrointestinal (33.3%) and respiratory (24.3%) conditions were the leading diagnoses at the index visit, and they remained the most common causes for return visits. While 70.9% of patients were triaged as "Urgent" (Priority 2) initially, nearly half (48.9%) were triaged as "Less urgent" (Priority 3) upon return. Only 6.4% of returning patients required hospital admission, while 48.2% were discharged after evaluation.
Conclusion
Early pediatric ED return visits in Karachi are predominantly associated with younger age (under two years) and common infectious illnesses. The shift toward lower triage acuity and low admission rates suggests that many revisits may be driven by parental concern or persistent symptoms rather than clinical deterioration. Targeted interventions, including enhanced caregiver education and improved discharge counseling, are recommended to reduce preventable revisits.