Obesity and the emergency short stay unit

Marc Marquez1, William McGuiness3, Rachel Cross1,3, Biswadev Mitra1,2

1 Emergency & Trauma Centre, The Alfred Hospital, Melbourne, Australia
2 Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Australia
3 La Trobe University School of Nursing and Midwifery, Alfred La Trobe Clinical School, Melbourne, Australia

Objectives: To evaluate the health service requirements of obese patients admitted to an Emergency Short Stay Unit (ESSU) and specifically compare length of stay (LOS), failure of ESSU management, and rates of investigations and allied health interventions among obese and non-obese patients.

Methods: A prospective cohort study, using convenience sampling was conducted. The body mass index (BMI) of participants was calculated and those with a BMI of ⩾30 were allocated to the obese group, and those that had a BMI of <30 to the non-obese group. Data collected included demographics, admission diagnosis, time and date of ESSU admission and discharge, discharge disposition, radiological investigations, and referrals made to allied health personnel during ESSU admission.

Results: There were 262 patients that were recruited sub-grouped into 127 (48.5%) obese participants and 135 (51.5%) non-obese participants with similar sex and diagnostic category distributions. The mean LOS in ESSU was similar – 11.5 h (95% CI: 9.9–13.1) for obese patients and, 10.2 h (95% CI: 8.8–11.6) for non-obese patients (p = 0.21). Failure rates of ESSU management, defined as inpatient admission to hospital, were also similar with 29 (22.8%) obese patients admitted to hospital compared to 25 (18.5%) non-obese patients (p = 0.39). Plain X-ray requests were significantly higher among obese patients (71.6 vs 53.3%; p = 0.002), as was the rate of allied health interventions (p = 0.001).

Conclusion: There was no significant difference in inpatient admission rates or LOS between obese and non-obese patients managed in the ESSU. Provisions for increased rate of investigations and allied health interventions for obese patients may facilitate timely assessment and disposition from ESSU.


Marc Marquez is a Clinical Nurse Specialist in the area of Emergency & Trauma nursing, with a background of six years clinical experience at The Alfred Hospital’s Emergency & Trauma Centre. Marc graduated from Victoria University with a Bachelor of Nursing in 2008. He has recently completed his Master of Nursing (Emergency Care) at La Trobe University, where an original research entitled ‘Obesity and the Emergency Short Stay Unit’ has been submitted and accepted by the International Emergency Nursing Journal for publication.  Since 2008, he’s had a variety of teaching experiences throughout different course levels, ranging from Certificate 3 & 4 Health Services courses to Initial Registration Course for Overseas Nurses (IRON). Marc has also been employed as a consultant and curriculum enhancer for IRON courses, including development of assessments and marking guides. He serves as a Nursing Officer for the Royal Australian Army Nursing Corps, and has been an active serving member of the Army Reserve for ten years. With a strong passion for the development of international healthcare standards, Marc is heavily involved with the Alfred Hospital’s international programs.