BACKGROUND: Obesity implies an adverse effect on outcome after appendectomy. This study aimed to determine whether obese patients with appendicitis should be managed differently than nonobese patients. METHODS: After appendectomy, all patients were enrolled in a prospective clinical pathway and followed from initial presentation to full outpatient recovery. RESULTS: In 1 year, 272 adults underwent appendectomy, 55 (22%) of whom were obese. The obese patients were slightly older (35 vs 33 years; p < 0.001). The time to diagnosis (8.5 vs 8.6 h), and the need for computed tomography (CT) scanning (40% vs 49%) was similar in both populations. The obese patients had similar rates of perforation (35% vs 35%) and laparoscopy (47% vs 41%). The median hospital length of stay (LOS) (2 days) and complications, including wound complications (9.1% vs 10.9%) and intraabdominal abscesses (3.6% vs 3.1%), were similar. Subgroup analysis showed a longer LOS for the obese patients with perforation than for the nonobese patients (6 vs 5.5 days; p = 0.036). CONCLUSION: Obese patients had no greater delay in diagnosis, had no greater need for CT scan, gained no additional benefit from laparoscopy, and did not incur significantly worse outcomes after appendectomy except for an increased LOS among those with perforation.
BACKGROUND: Obesity implies an adverse effect on outcome after appendectomy. This study aimed to determine whether obesepatients with appendicitis should be managed differently than nonobese patients. METHODS: After appendectomy, all patients were enrolled in a prospective clinical pathway and followed from initial presentation to full outpatient recovery. RESULTS: In 1 year, 272 adults underwent appendectomy, 55 (22%) of whom were obese. The obesepatients were slightly older (35 vs 33 years; p < 0.001). The time to diagnosis (8.5 vs 8.6 h), and the need for computed tomography (CT) scanning (40% vs 49%) was similar in both populations. The obesepatients had similar rates of perforation (35% vs 35%) and laparoscopy (47% vs 41%). The median hospital length of stay (LOS) (2 days) and complications, including wound complications (9.1% vs 10.9%) and intraabdominal abscesses (3.6% vs 3.1%), were similar. Subgroup analysis showed a longer LOS for the obesepatients with perforation than for the nonobese patients (6 vs 5.5 days; p = 0.036). CONCLUSION:Obesepatients had no greater delay in diagnosis, had no greater need for CT scan, gained no additional benefit from laparoscopy, and did not incur significantly worse outcomes after appendectomy except for an increased LOS among those with perforation.
Authors: Carolyn A Mendez-Luck; Hongjian Yu; Ying-Ying Meng; Mona Jhawar; Steven P Wallace Journal: Policy Brief UCLA Cent Health Policy Res Date: 2005-04
Authors: Raul N Uppot; Dushyant V Sahani; Peter F Hahn; Mannudeep K Kalra; Sanjay S Saini; Peter R Mueller Journal: Radiology Date: 2006-06-26 Impact factor: 11.105
Authors: Cynthia L Ogden; Margaret D Carroll; Lester R Curtin; Margaret A McDowell; Carolyn J Tabak; Katherine M Flegal Journal: JAMA Date: 2006-04-05 Impact factor: 56.272
Authors: Grant V Bochicchio; Manjari Joshi; Kelly Bochicchio; Shelly Nehman; J Kathleen Tracy; Thomas M Scalea Journal: J Am Coll Surg Date: 2006-09-01 Impact factor: 6.113