Obesity is a growing epidemic in the United States. A disproportionately high percentage of the obese population is admitted to our nation's hospitals, and once admitted these patients have lengths of stay almost twice as long and cost thousands of dollars more than those of their nonobese counterparts, The opportunity to intervene on obese patients is lost if hospitalists are unable to accurately recognize obesity in their inpatient population. Our study investigated whether hospitalist providers can accurately assess the weight status of their patients. A secondary aim was to understand whether specific provider and patient characteristics affect their precision.
We evaluated the frequency with which body mass index (BMI) was accurately assessed by hospitalists in their inpatient population by performing an observational cohort study on the hospitalist service of an academic center. After providers had interviewed and examined their patients, they were asked to visually reassess the patient to estimate their BMI category as underweight, normal, overweight, obese, or morbidly obese. BMI categories were defined based on the National Institute of Health clinical guidelines (NIH, 1998). A list of BMI categories (underweight, normal weight, overweight, obese, morbidly obese) was provided to all providers at the time of assessment.
Two hundred and nineteen patients and 20 providers were included in the study. Sixty‐nine percent of the patients were overweight or greater. The patient's BMI category was incorrectly assessed by our providers approximately half the time (48%). When the assessment was incorrect, the provider tended to underestimate the patient's weight status twice as often as they overestimated it (65% versus 35%, respectively), Provider age, sex, race, BMI, years of experience, or training (physician vs. physician assistant) did not increase the likelihood of correctly assessing the weight status of their patients (all P > 0.05).
Although the inpatient setting is set up to preferentially address acute medical issues that necessitate admission, hospitalist providers can also seize the moment to address chronic medical issues such as obesity. However, these conversations cannot take place if hospitalists do not first recognize and accurately assess the weight status of their patients. This study emphasizes the need for provider‐centered obesity training to help in the recognition of weight status in obese patients. Such recognition could be tied to efforts that can promote weight reduction during and after the hospitalization.
E. Howe, Johns Hopkins Bayview Medical Center, employment; J. Record, Johns Hopkins Bayview Medical Center, employment; F. Kisuule, Johns Hopkins Bayview Medical Center, employment; R. Landis, Johns Hopkins Bayview Medical Center, employment; S. Wright, Johns Hopkins Bayview Medical Center, employment.
To cite this abstract:Howe E, Kisuule F, Record J, Landis R, Wright S. Recognition of Body Mass Index in the Inpatient Population by Hospitalist Providers. Abstract published at Hospital Medicine 2010, April 8-11, Washington, D.C. Abstract 69. Journal of Hospital Medicine. 2010; 5 (suppl 1). https://www.shmabstracts.com/abstract/recognition-of-body-mass-index-in-the-inpatient-population-by-hospitalist-providers/. Accessed August 23, 2019.