title: The correlation between body mass index, limb circumferences and blood pressure cuff fit in bariatric surgical patients.
abstract: BACKGROUND
  The purpose of this study was to determine the correlation between body mass index (BMI) and upper and lower arm as well as lower leg circumferences and the frequency of correct blood pressure (BP) cuff fit. We explored recommendations for the most likely BP cuff size and location for the three BMI categories.
  
  
  METHODS
  Following IRB approval we retrospectively analyzed a research database of bariatric surgical patients with a BMI of ≥40 kg/m(2). Data included patients' characteristics, upper and lower arm as well as lower leg circumferences. Patients were divided into three groups based on BMI (kg/m(2), Group I: <45, Group II: 45-55, and Group III: >55). Appropriate cuff fit using a standard or large adult BP cuff (CRITIKON(®), GE Healthcare, Waukesha, Wisconsin, USA) on the upper and lower arm, and lower leg was determined. We analyzed the percent proportion of proper cuff fit for cuff sizes and locations between groups using appropriate nonparametric testing.
  
  
  RESULTS
  Limb circumference correlated significantly with BMI (P = 0.01), and the upper arm correlated most closely (r = 0.76). A standard adult BP cuff on the lower arm fit properly in >90% and >80% and in Groups I and II, respectively. A large cuff on the lower arm was appropriate in 87% of Group III. In two participants, a large cuff fit properly on the lower leg.
  
  
  CONCLUSIONS
  Limb circumference significantly correlated with BMI. Recommendations for proper cuff fit in different BMI categories can be made.
authors.affiliation: Department of Anesthesiology, Tufts Medical Center, Boston, MA, USA.
authors.forename: R
authors.initials: R
authors.lastname: Schumann
authors.affiliation: Department of Anesthesiology, Tufts Medical Center, Boston, MA, USA; Department of Anesthesiology, Detroit Medical Center, Detroit, MI, USA, and Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: O
authors.initials: O
authors.lastname: Alyamani
authors.affiliation: Department of Oral and Maxillofacial Surgery, Tufts University School of Medicine, Boston, MA, USA.
authors.forename: A
authors.initials: A
authors.lastname: Viswanath
authors.affiliation: Department of Anesthesiology, Tufts Medical Center, Boston, MA, USA.
authors.forename: I
authors.initials: I
authors.lastname: Bonney
keywords: Arm circumference; bariatric; blood pressure; cuff fit; obesity