Prendergast Heather M, Waintraub Ernest, Bunney Brad, Gehm Lisa, Tyo Carissa, Marquez Armando, Williams John, Bailey Angela, Marquez Diego, Edison Marcia, Mackey Mark
Department of Emergency Medicine, University of Illinois, Chicago, USA.
Emergency Medicine Residency Program, University of Illinois, Chicago, USA.
Int J Clin Med. 2013 May;4(5):268-272. doi: 10.4236/ijcm.2013.45047.
Reviews adult emergency department (ED) visits for patients age 65 and older during one calendar year; determine the prevalence of weight classifications; identifies trends between BMI and discharge/admitting diagnoses, vital signs, and severity index.
The electronic medical records system and data from the ED billing service was reviewed for an urban academic institution with an annual volume of 125,000 for patients age > 65. Using a random number table, a retrospective cohort of 328 elderly patients was selected for review, representing a convenience sample of 2.6% of elderly ED visits. Body Mass Index (BMI) was calculated, using the Center for Disease Control (CDC) formula with underweight (<18.5), normal (18.5 - 24.9), overweight (25 - 29.9), and obese (≥30).
The majority of the cohort in this study was African-American and Hispanic (60% and 27% respectively), and there were a higher percentage of females than males (60% and 40% respectively). Approximately 29% of the patients were classified as normal weight, 35% classified as overweight, and 36% as obese. The older the patient, the more likely that patient belonged to a lower weight classification (p < 0.01). Those presenting with neurological, pulmonary or gastrointestinal complaints were more likely to be of a higher weight classification (p < 0.05). Patients who were hypertensive on arrival to the ED were more likely to be in a higher weight classification (p < 0.01).
Those patients with a higher weight classification had a strong correlation with selected abnormal vital signs and disease presentations. EDs are important sources of care for the elderly. EDs can serve as a previously untapped resource for screening and early referral exercise programs aimed at improving physical function/functional status and quality of life in the elderly patient population.
回顾一个日历年中65岁及以上成人在急诊科（ED）的就诊情况；确定体重分类的患病率；找出体重指数（BMI）与出院/入院诊断、生命体征及严重程度指数之间的趋势。
对一家年就诊量达125,000人次的城市学术机构中年龄大于65岁患者的电子病历系统及急诊计费服务数据进行回顾。使用随机数表，选取328例老年患者的回顾性队列进行分析，该队列占老年急诊就诊患者的2.6%，为便利样本。采用美国疾病控制中心（CDC）公式计算体重指数（BMI），将体重状况分为体重过轻（<18.5）、正常（18.5 - 24.9）、超重（25 - 29.9）和肥胖（≥30）。
本研究队列中大多数为非裔美国人和西班牙裔（分别占60%和27%），女性比例高于男性（分别占60%和40%）。约29%的患者体重分类为正常，35%为超重，36%为肥胖。患者年龄越大，体重分类越低的可能性越大（p < 0.01）。出现神经、肺部或胃肠道症状的患者体重分类较高的可能性更大（p < 0.05）。到达急诊科时患有高血压的患者体重分类较高的可能性更大（p < 0.01）。
体重分类较高的患者与某些异常生命体征及疾病表现密切相关。急诊科是老年人重要的医疗服务来源。急诊科可作为一个此前未被充分利用的资源，用于筛查及早期转诊运动项目，旨在改善老年患者群体的身体功能/功能状态及生活质量。
