Platts-Mills Timothy F, Burg Michael D, Snowden Brandy
Department of Emergency Medicine, University of California San Francisco, Fresno, CA, USA.
Acad Emerg Med. 2005 Aug;12(8):778-81. doi: 10.1197/j.aem.2005.03.522.
The authors describe the evaluation of obese and nonobese adult patients with abdominal pain presenting to an emergency department (ED). The hypothesis was that more ED and hospital resources are used to evaluate and treat obese patients.
A prospective observational study of obese (n = 98; body mass index > or = 30 kg/m2) and nonobese (n = 176; body mass index < 30 kg/m2) adults presenting to the ED with abdominal pain was performed. ED length of stay (LOS) was the primary outcome. Secondary outcomes included use of laboratory tests, computed tomography, and ultrasonography, and rates of consultations, operations, and admissions. ED diagnoses were compared between the two groups.
Obese patients were older (41.9 vs. 38.3 years; p = 0.027) and more often female (69% vs. 51%; p = 0.003) than nonobese patients. There were no significant differences between obese and nonobese patients in either the primary or the secondary outcome measures. Obese patients were similar to nonobese patients in regard to LOS (457 vs. 486 minutes), laboratory studies (3.2 vs. 2.9 tests), abdominopelvic computed tomographic scans (30% vs. 31%), and abdominal ultrasounds (16% vs. 13%). Obese and nonobese patients were also similar in their rates of consultations (27% vs. 31%), operations (14% vs. 12%), and admissions (18% vs. 24%). No difference was found for LOS between obese and nonobese patients as evaluated by the Wilcoxon rank-sum test (p = 0.81). Logistic regression analysis controlling for baseline characteristics revealed no significant differences between obese and nonobese patients for secondary outcome variables. ED diagnoses for obese and nonobese patients were similar except that genitourinary diagnoses were less common in obese patients (8% vs. 21%; p = 0.01).
In contradiction to the hypothesis, the results suggest that LOS and ED resource use in obese patients with abdominal pain are not increased when compared with nonobese patients.
作者描述了对急诊科就诊的肥胖和非肥胖成年腹痛患者的评估情况。假设是评估和治疗肥胖患者需要更多的急诊科和医院资源。
对急诊科就诊的肥胖（n = 98；体重指数≥30 kg/m²）和非肥胖（n = 176；体重指数<30 kg/m²）成年腹痛患者进行了一项前瞻性观察研究。急诊科住院时间（LOS）是主要结局指标。次要结局指标包括实验室检查、计算机断层扫描和超声检查的使用情况，以及会诊、手术和住院率。比较了两组患者的急诊科诊断结果。
肥胖患者比非肥胖患者年龄更大（41.9岁对38.3岁；p = 0.027），女性比例更高（69%对51%；p = 0.003）。肥胖和非肥胖患者在主要或次要结局指标方面均无显著差异。肥胖患者与非肥胖患者在住院时间（457分钟对486分钟）、实验室检查（3.2项对2.9项）、腹部盆腔计算机断层扫描（30%对31%）和腹部超声检查（16%对13%）方面相似。肥胖和非肥胖患者在会诊率（27%对31%）、手术率（14%对12%）和住院率（18%对24%）方面也相似。通过Wilcoxon秩和检验评估，肥胖和非肥胖患者的住院时间无差异（p = 0.81）。控制基线特征的逻辑回归分析显示，肥胖和非肥胖患者在次要结局变量方面无显著差异。肥胖和非肥胖患者的急诊科诊断相似，只是肥胖患者的泌尿生殖系统诊断较少见（8%对21%；p = 0.01）。
与假设相反，结果表明与非肥胖患者相比，肥胖腹痛患者的住院时间和急诊科资源使用并未增加。
