title: Morbidly obese patients receive delayed ED care: body mass index greater than 40 kg/m2 have longer disposition times.
abstract: OBJECTIVE
  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.
authors.affiliation: CHRISTUS Spohn Memorial Hospital, EM Residency Program, Corpus Christi, TX 78405, USA. jerry@jrbaskerville.com
authors.forename: Jerry Ray
authors.initials: JR
authors.lastname: Baskerville
authors.forename: Robert K
authors.initials: RK
authors.lastname: Moore
mesh_terms: D000328:Adult; D015992:Body Mass Index; D016022:Case-Control Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D009765:Obesity / Q000628:therapy; D009767:Obesity, Morbid / Q000628:therapy*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data