• Orlando De Jesus, Rodríguez BeatoFreddieFSection of Neurosurgry, Department of Surgery, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico, USA., and Aixa de Jesús Espinosa.
• Section of Neurosurgry, Department of Surgery, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico, USA. Electronic address: drodejesus@aol.com.
• World Neurosurg. 2022 Feb 1; 158: e283-e286.

ObjectiveThis study evaluated emergency department (ED) neurosurgical reevaluation rates and their causes. Identifying the most significant reasons that make patients return to the ED for a neurosurgical reevaluation can help implement changes to reduce the economic and medical burden of patient turnover.MethodsAll patients undergoing neurosurgical reevaluation at our institution's ED after an initial neurosurgical evaluation were enrolled in a prospective 3-month longitudinal registry. Inclusion criteria were all adult patients 21 years of age or older previously evaluated by neurosurgery at our institution's ED who return within 90 days for a neurosurgical reevaluation.ResultsWe found an overall 90-day ED neurosurgical return visit rate of 2.1%. During the study, 34 patients returned to the ED for a neurosurgical reevaluation. Patients returned for a neurosurgical reevaluation at a median of 23.5 days after the initial neurosurgery evaluation. The principal causes for a return visit were altered mental status, headache, and wound infections. Among the returning patients, 59% required hospitalization and 50% required an operation.ConclusionsTo our knowledge, this is the first study to prospectively collect data to estimate the 90-day ED return visit rate for a neurosurgical reevaluation following an initial ED neurosurgical evaluation. Some patients still use the ED to get continued care of their condition despite having access to their primary care physician. Better communication, social worker coordination, and prompt follow-up appointments at the neurosurgical outpatient clinic may reduce return visits.Copyright © 2021 Elsevier Inc. All rights reserved.

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