Patient factors associated with 30-day emergency department revisits after initial presentation with otologic conditions

Otologic disease can escalate to hearing loss, intracranial infection, and excess costs if not definitively managed. Characterizing patient factors associated with emergency department (ED) revisits could guide proactive follow-up, improving outcomes and resource use. This was a single center, retrospective study of patients who initially presented with a spectrum of external ear, middle ear, and mastoid disease (International Classification of Disease codes H60-H67, H70-H75). Clinical and sociodemographic information and ED revisit status were abstracted, and multivariable logistic regression was used to identify predictors of return to ED within 30 days. In total, 995 patients were identified with 458 (46.0 %) females and a mean (SD) age of 34.5 (26.6) years at ED presentation. The most common diagnoses were suppurative otitis media ( n = 291, 29.2 %) or otitis externa ( n = 271, 27.2 %). One-hundred fifty-eight (15.9 %) patients revisited the ED within 30 days. Black patients (odds ratio [OR] 1.60 95 % confidence interval [CI] 1.02–2.53, p = 0.041), current smokers (OR 2.09, 95 % CI 1.23–3.51, p = 0.006), and patients with higher Charlson comorbidity scores (OR 1.16, 95 % CI 1.05–1.29, p = 0.005) were more likely to revisit the ED within 30 days. Admission at the time of initial presentation was associated with a lower risk of revisit (OR 0.52, 95 % CI 0.32–0.83, p = 0.006). Black patients, active smokers, and patients with higher comorbidity scores who initially presented with ear conditions were more likely to revisit the ED, while inpatient admission reduced revisits. These results provide insight into patient factors necessitating closer follow-up and more intensive interventions for otologic diagnoses.