Background: Accurate and timely documentation of obesity in Electronic Medical Records (EMRs) is essential for risk stratification, clinical management and health service planning. However, obesity documentation is often missing, and its association with resource utilisation metrics among hospitalised cardiorespiratory patients remains unclear.
Methods: A retrospective clinical audit was conducted across acute cardiology and respiratory wards at Royal Prince Alfred Hospital. EMRs were reviewed for documentation of height, weight, obesity status, complications, intensive care unit (ICU) admission and discharge diagnoses. Median length of stay (LOS) was compared by obesity status using the Mann-Whitney U test. A multivariable linear regression model evaluated the independent association between obesity and LOS, after adjustment for age and ward allocation. ICU admission and hospital-acquired complication rates were compared between patients by obesity status.
Results: EMRs were reviewed for 63 patients in cardiology (n=26) and respiratory (n=37) wards. Height and weight were documented for 87.3% (n=55) of patients while only one patient (1.6%) lacked both. Fourteen patients (22.2%) had obesity. Despite this, obesity was explicitly documented in only one discharge summary (1.6%). Patients with obesity had a similar median LOS than those without obesity (12.5 vs 9.0 days, p=0.274). In adjusted analyses LOS was estimated to be 6.16 days longer among patients with obesity, but the difference did not reach statistical significance (p=0.129). Age (p=0.980) and ward allocation (p=0.282) were not independently associated with LOS. ICU admission rates did not differ significantly between groups (p>0.05). However, people with obesity had more hospital acquired complications, 50.0% vs 17.1% (p=0.029).
Conclusions: Obesity affected more than one in five patients on cardiology and respiratory wards but was documented in only one discharge summary, indicating substantial under-recognition despite high rates of height and weight documentation. Obesity was associated with more hospital acquired complications. Improving recognition and documentation of obesity may enhance risk stratification, resource planning and continuity of care.