Jerry Ray Baskerville1, Robert K Moore. 1. CHRISTUS Spohn Memorial Hospital, EM Residency Program, Corpus Christi, TX 78405, USA. jerry@jrbaskerville.com
Abstract
OBJECTIVES: Our study compares treatment times of morbidly obese patients (body mass index [BMI]>40 kg/m2) with patients having BMI less than 35 kg/m2. METHODS: We used an institutional review board-approved, retrospective, sequential, cohort, data analysis of emergency department (ED) medical records from our county teaching hospital (January 2010). Our data set of 102 morbidly obese patients (World Health Organization class 3 [BMI>40 kg/m2]) was compared with that of 195 normal or mildly obese patients (World Health Organization class 0 or 1 [BMI<35 kg/m2]). Inclusion was limited to patients of Emergency Severity Index level 2 and 3 who presented for triage. The primary outcome variable was total length of stay for patients discharged home from the ED. RESULTS: Morbidly obese patients take significantly longer to disposition than normal or mildly obese patients (difference, 101 minutes [95% CI, 55-146]; P<.0001). The mean length of stay for patients with BMI less than 35 kg/m2 was 287 minutes in contrast to 388 minutes for patients with BMI greater than 40 kg/m2. Computed tomography use was significantly less likely in the BMI class 0 and 1 groups compared with the BMI class 3 group (0.41 [79/195] vs 0.56 [57/102]; difference, 0.15 [95% CI, 0.03-0.27]; P=.012). CONCLUSIONS: In our institution, morbidly obese patients take significantly longer to disposition home than patients of more normal weight.
OBJECTIVES: Our study compares treatment times of morbidly obesepatients (body mass index [BMI]>40 kg/m2) with patients having BMI less than 35 kg/m2. METHODS: We used an institutional review board-approved, retrospective, sequential, cohort, data analysis of emergency department (ED) medical records from our county teaching hospital (January 2010). Our data set of 102 morbidly obesepatients (World Health Organization class 3 [BMI>40 kg/m2]) was compared with that of 195 normal or mildly obesepatients (World Health Organization class 0 or 1 [BMI<35 kg/m2]). Inclusion was limited to patients of Emergency Severity Index level 2 and 3 who presented for triage. The primary outcome variable was total length of stay for patients discharged home from the ED. RESULTS: Morbidly obesepatients take significantly longer to disposition than normal or mildly obesepatients (difference, 101 minutes [95% CI, 55-146]; P<.0001). The mean length of stay for patients with BMI less than 35 kg/m2 was 287 minutes in contrast to 388 minutes for patients with BMI greater than 40 kg/m2. Computed tomography use was significantly less likely in the BMI class 0 and 1 groups compared with the BMI class 3 group (0.41 [79/195] vs 0.56 [57/102]; difference, 0.15 [95% CI, 0.03-0.27]; P=.012). CONCLUSIONS: In our institution, morbidly obesepatients take significantly longer to disposition home than patients of more normal weight.