Effects of obesity on patient experience in the emergency department

The study aims to determine if obesity (body mass index ≥30.0 kg/m(2) ) adversely affects the patients' ED experience in terms of flow variables and rates of assistance, investigation and procedure.

This was a prospective, analytical, observational study in a large tertiary referral ED. Consecutive patients, presenting during data collection periods, were enrolled after they had received ≥3 h of care. Height and weight data were collected from the patient; demographics, presenting complaint, triage category, time to be seen and modes of arrival and disposition from the Emergency Department Information System, and investigations from the electronic pathology and radiology records. Data on a wide range of procedures and management variables were collected directly from the ED staff using a specifically designed survey instrument.

Seven hundred and eleven patients were enrolled (mean age 64.3 ± 18.6 years, 375 [52.7%] male). One hundred and ninety-one (26.9%, 95% confidence interval 23.7-30.3) patients were obese. Obese patients were significantly younger than non-obese patients (median 63 vs 70 years, P < 0.001). They had significantly more intravenous cannulation attempts, liver function tests (69.1% vs 60.2%), cardiac enzyme tests (40.8% vs 30.0%) and abdominal X-rays (17.8% vs 8.7%) (P < 0.05). There were no differences between the groups in time to be seen, monitoring, other procedures, assistance required, place of disposition or ED length of stay (P > 0.05). Obese patients had a lower death rate in the ED or hospital than non-obese patients (1.6% vs 7.5%, P < 0.01).

In this single-centre study, obesity did not appear to adversely affect ED treatment. The observed differences in some investigation rates might relate to suspected morbidities and difficulties in physical examination.