Factors Associated with Thirty-Day Emergency Department Revisits for Upper Gastrointestinal Bleeding: Insights from a Five-Year Retrospective Study

Aim: This study aims to identify key factors associated with 30-day emergency department (ED) revisits among patients discharged after upper gastrointestinal bleeding (UGIB), providing insights to optimize patient management and improve outcomes. Material and Methods: A single-center retrospective cohort study was conducted at a tertiary university hospital between January 1, 2018, and December 31, 2022. Adult patients (>18 years) diagnosed with UGIB were included, while those with incomplete data or transferred to other facilities were excluded. Data on demographics, clinical features, laboratory parameters, endoscopic findings, and revisits were analyzed. Univariate and multivariate logistic regression models were used to identify predictors of UGIB-related ED revisits. Results: Among 862 patients, the 30-day revisit rate was 19.9%, with 84 revisits related to UGIB. Female gender, malignancy, anticoagulant use, prior UGIB history, and lower discharge hemoglobin levels were identified as significant predictors of UGIB-related revisits. Patients with Forrest IA ulcers had a 42.9% revisit rate, while those with Forrest III ulcers showed a significantly lower rate of 5.5%. Erythrocyte suspension was used more frequently in the revisit group (83.3% vs. 61.2%, p<0.001), reflecting the severity of these cases. Conclusion: UGIB-related revisits are influenced by several factors, including anticoagulant use, malignancy, prior UGIB history, and endoscopic findings. Tailored discharge planning, patient education, and risk stratification are critical to reducing revisits. Future studies should focus on prospective validation and the development of predictive models for targeted interventions.