Effects of obesity on patient experience in the emergency department

MedicalResearch.com eInterview with Professor David McDonald Taylor
Emergency Department, Austin Health
PO Box 5555, Heidelberg, Vic. 3084, Australia

MedicalResearch.com: What are the main findings of the study?

Answer: Overall, obese and non-obese patients have similar experiences during their ED stay. However, while obese patients tend to be younger and less sick, their more frequent presentation with potentially cardiac-related disease is reflected in their management. The excess of liver function tests and abdominal xrays performed on obese patients is likely to reflect examination difficulties and over investigation. Obese patients do experience more attempts at IV cannulation.

Were any of the findings unexpected?

Answer: There is anecdotal evidence that obese ED patients have a considerably different experience in the ED. As well, there is published evidence indicating stigmata surrounding obese patients and an aversion to become engaged with their care. We undertook this study, therefore, in order to characterize the nature and extent of the difference in the ED experience of obese patients. It was unexpected, therefore, that the experience of obese patients differs little from that of non-obese patients.

MedicalResearch.com: What should clinicians and patients take away from your report?

Answer: The findings are encouraging and do not support the anecdotal and some published evidence. Clinicians can be confident that their management is not substantially affected by their patients’ morphology and that significant over-investigation is not being undertaken. Obese patients can be assured that, should they need to present to an ED, their management will differ little from that of others.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Answer:  We recommend multicentre studies to investigate further the effects of obesity among ED patients. Such studies should be sufficiently powered to explore the use of investigations and the performance of procedures, and control of confounding variables should be undertaken. If management difficulties and differences are confirmed, ways in which these can be mitigated should be explored.


Effects of obesity on patient experience in the emergency department

Ngui, B., Taylor, D. M. and Shill, J.
Emergency Medicine Australasia. doi: 10.1111/1742-6723.12065 (2013),