TITLE:
The Aging Waistline: Impact of the Geriatric Obesity Epidemic on an Urban Emergency Department: Original Communication
AUTHORS:
Heather M. Prendergast, Ernest Waintraub, Brad Bunney, Lisa Gehm, Carissa Tyo, Armando Marquez, John Williams, Angela Bailey, Diego Marquez, Marcia Edison, Mark Mackey
KEYWORDS:
Elderly; Obesity; Emergency Department
JOURNAL NAME:
International Journal of Clinical Medicine,
Vol.4 No.5,
May
20,
2013
ABSTRACT: Purpose: 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.Methods: 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 (- 24.9), overweight (25 - 29.9), and obese (≥30). Results: 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). Conclusion: 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.