University of Melbourne, Melbourne, Victoria, Australia.
Emerg Med Australas. 2013 Jun;25(3):227-32. doi: 10.1111/1742-6723.12065. Epub 2013 Apr 8.
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.
本研究旨在确定肥胖（身体质量指数≥30.0kg/m2）是否会对患者的 ED 体验产生不利影响，具体表现在流量变量和援助、检查和治疗的比例上。
这是一项在大型三级转诊 ED 进行的前瞻性、分析性、观察性研究。在数据收集期间，连续纳入接受≥3 小时护理的患者。从患者处收集身高和体重数据；从急诊部信息系统中收集人口统计学、就诊主诉、分诊类别、就诊时间、到达和出院方式；从电子病理学和放射学记录中收集检查信息。使用专门设计的调查工具，从 ED 工作人员处收集广泛的程序和管理变量数据。
共纳入 711 例患者（平均年龄 64.3±18.6 岁，375[52.7%]为男性）。191 例（26.9%，95%置信区间 23.7-30.3）患者肥胖。肥胖患者明显比非肥胖患者年轻（中位数 63 岁比 70 岁，P<0.001）。他们接受了更多的静脉穿刺尝试、肝功能检查（69.1%比 60.2%）、心脏酶检查（40.8%比 30.0%）和腹部 X 射线检查（17.8%比 8.7%）（P<0.05）。两组在就诊时间、监测、其他程序、所需援助、出院地点或 ED 住院时间方面无差异（P>0.05）。肥胖患者在 ED 或医院的死亡率低于非肥胖患者（1.6%比 7.5%，P<0.01）。
在这项单中心研究中，肥胖似乎并没有对 ED 治疗产生不利影响。观察到的某些检查率差异可能与疑似合并症和体检困难有关。
