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A recent hospital stay flagged short-term return risk in older ED patients

Journal of the Formosan Medical Association = Taiwan yi zhi (PubMed)Aug 29, 2026

AI-summarized from the linked source. Educational brief, not medical advice.

Brief summary

A prospective Taiwanese study found that recent hospitalization within six months was independently associated with 3-day ED revisits and readmissions among older adults.

What NurseJet pulled from the source

Among 9,697 eligible ED patients aged 65 or older, trained nurses completed ISAR screening for 3,039. The ISAR item asking about hospitalization in the prior six months was associated with both a 3-day ED revisit (OR 1.852) and 3-day readmission (OR 2.290), making it a potential prompt for focused transition planning rather than a stand-alone disposition rule.

Why this matters for nurses

A recent admission is easy to capture during triage and can reveal a patient who may need closer medication reconciliation, discharge teaching, follow-up coordination, or reassessment before leaving acute care.

Bedside takeaway

Ask about hospitalization in the past six months and treat a positive answer as a cue for closer transition-risk assessment.

How This Applies in Practice

Use this when: Triaging or planning discharge for an emergency patient aged 65 years or older.

On your shift

Ask whether the patient was hospitalized during the previous six months and verify dates and reasons when records are available.
Review current symptoms, medication changes, functional status, caregiver support, and follow-up barriers as part of the complete assessment.
Communicate a recent admission and unresolved transition risks to the treating and discharge-planning teams.

Keep in mind: One ISAR item is a risk flag, not a disposition rule. Follow the emergency assessment pathway, facility policy, and provider orders.

Key takeaways

The prospective study included 9,697 eligible older ED patients, but only 3,039 underwent ISAR screening.
Recent hospitalization within six months was associated with 3-day ED revisits and readmissions.
The reported odds ratios were 1.852 for an ED revisit and 2.290 for readmission.
The study supports risk flagging, not using one question as a substitute for clinical assessment or disposition planning.

Practice implications

Ask older patients or caregivers about hospital stays during the previous six months and verify the history when possible. If present, incorporate it into the full risk assessment and communicate unresolved symptoms, medication changes, support gaps, or follow-up barriers.

Limitations & cautions

This was a single-community-hospital study in Taiwan, and fewer than one-third of eligible patients were screened. The observational association does not prove that recent hospitalization causes return visits or that acting on the item alone prevents them.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations

Exact source links

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Journal of the Formosan Medical Association = Taiwan yi zhi (PubMed)

Journal of the Formosan Medical Association = Taiwan yi zhi (PubMed). Recent admissions are a risk indicator for returning emergency room (ER) visits and readmissions: screening using Identification of Seniors at Risk (ISAR).

Open original source

https://pubmed.ncbi.nlm.nih.gov/42668217/

Professional education only

This summary does not replace clinical judgment, facility policy, provider orders, or official guidelines. Verify practice changes against the original source and local protocol.

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A single-center retrospective cohort found that approximately one quarter of laboratory-defined acute kidney injury cases on internal medicine wards were not documented, particularly when maximal creatinine was lower.

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Among 161 adult hospitalizations meeting serum-creatinine criteria for acute kidney injury, 39 cases (24.2%) were undocumented. Length of stay and in-hospital mortality did not differ significantly by documentation status.

Key takeaways

In the 149 hospitalizations with a demonstrable creatinine change, 33 cases (22.1%) were undocumented.
Higher maximal creatinine was associated with lower adjusted odds of underdocumentation.
The study did not test whether a detection or documentation intervention improves care or outcomes.

Why this matters on shift

A smaller creatinine rise may receive less attention even when it meets the study's laboratory definition of acute kidney injury, which can affect how renal risk is communicated across the inpatient team.

Bedside takeaway

Trend ordered renal-function results and communicate clinically important changes through local escalation and documentation workflows.

Nursing implications

Trend ordered renal-function results and communicate clinically important changes through the care team according to local escalation and documentation workflows.

Limitations & cautions

Abstract-only summary. This was a retrospective, single-center study of 161 hospitalizations; urine-output criteria and reliable preadmission creatinine values were unavailable, and the reference creatinine method may affect case classification.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Renal failure (PubMed). Underdocumentation of laboratory-defined acute kidney injury in internal medicine wards: a retrospective cohort study.

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AI-summarized from the linked source. Review the original article before applying to practice.

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A double-blind randomized trial found no reduction in vomiting or faster oral tolerance with intravenous pantoprazole versus placebo in children with acute gastroenteritis and persistent vomiting after ondansetron.

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The trial randomized 100 children. Vomiting episodes and oral tolerance at 6 and 12 hours did not differ significantly, while median hospital stay was 2 days with pantoprazole and 1 day with placebo.

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The median participant age was 14 months, and 67% of participants were male.
Oral tolerance at 12 hours was 86% in both groups.
The longer stay associated with pantoprazole requires cautious interpretation because this was a single-center trial.

Why this matters on shift

The trial does not support empiric intravenous proton-pump inhibition for persistent vomiting in pediatric acute gastroenteritis after ondansetron.

Bedside takeaway

Clarify the indication for empiric acid suppression and keep hydration and oral-tolerance assessment central to care.

Nursing implications

Prioritize the ordered hydration and oral-tolerance plan, document ongoing emesis, and clarify the indication before administering empiric acid suppression.

Limitations & cautions

Abstract-only summary. This was a single-center study of 100 children in Tehran, and the abstract does not describe adverse events or explain why hospitalization was longer in the pantoprazole group.
AI-summarized from the linked source. Review the original article before applying to practice.

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Pediatric emergency care (PubMed). Effect of Intravenous Pantoprazole on Clinical Outcomes in Pediatric Acute Gastroenteritis: A Placebo-Controlled RCT.

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In the pragmatic TARGET-D randomized trial, vitamin D dosing titrated to a serum target did not significantly reduce the composite of death, recurrent myocardial infarction, heart-failure hospitalization, or stroke after myocardial infarction.

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Among 630 participants followed for an average of 4.2 years, major cardiovascular events occurred in 15.7% with targeted vitamin D management and 18.4% with usual care (hazard ratio 0.85, 95% CI 0.58 to 1.24; P=0.40).

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At baseline, 87% of participants had a 25-hydroxyvitamin D level of 40 ng/mL or lower.
The primary composite outcome and the individual outcomes of death, heart-failure hospitalization, and stroke were not significantly different.
A lower recurrent-MI rate was a secondary finding and should not override the nonsignificant primary result.

Why this matters on shift

The trial cautions against presenting targeted vitamin D supplementation as a proven strategy for reducing major cardiovascular events after myocardial infarction.

Bedside takeaway

Present vitamin D as prescribed supplementation, not as a replacement for established post-MI secondary prevention.

Nursing implications

Reinforce the prescribed secondary-prevention plan and avoid implying that vitamin D replaces therapies with established post-MI benefit.

Limitations & cautions

Abstract-only summary. The trial included 630 participants, 78.1% were men, the primary confidence interval included benefit and no benefit, and individual secondary outcomes were not the primary endpoint.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

European heart journal (PubMed). Targeted vitamin D supplementation and major adverse cardiovascular events after myocardial infarction: the TARGET-D trial.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

How This Applies in Practice

Key takeaways

Practice implications

Limitations & cautions

Exact source links

More updates for this clinical area

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