Incidence, clinical course, and perioperative outcomes of appendicitis in obese: a retrospective study

Abstract

Objective: This study aimed to assess the incidence of acute appendicitis in obese patients and to comprehensively assess how obesity impacts its clinical course and perioperative outcomes. Methods: A cross-sectional retrospective study was conducted to explore the incidence of appendicitis among obese patients over 2 years (2021-2022) in one center in Taif City, Saudi Arabia. Results: The appendicitis rate was 9.8% among all patients and 2.7% among obese patients. Adult patients had a median interquartile range (IQR) age of 28 (13) years, while children had a (IQR) age of 11. The median of systolic blood pressure (SBP) was affected by their body mass index (BMI) (non-obese vs. obese adults, 120.5 vs. 134 mmHg; p-value = 0.022) (non-obese vs. obese children, 110 vs. 122 mmHg; p-value = 0.048). The median heart rate of obese children was significantly lower than that of non-obese children (73% vs. 95%) (p-value = 0.019). Abnormal computed tomography (CT) findings were higher among obese patients as compared to non-obese (37.5% vs. 1.8%) (p-value = 0.003). The rate of open appendectomy was higher in nonobese patients (adults: 64.5% vs. 25%, p-value = 0.046) (children: 70.9% vs. 0%, p-value = 0.016). Antibiotic administration for appendicitis management was significantly higher among obese children (66.7%) than others (7.7%) (p-value = 0.022). Conclusion: Lower rate of appendicitis was observed in obese patients. This study highlighted the importance of BMI in appendicitis management. BMI can affect vital signs, such as SBP or heartbeat rate, surgical method choice, surgery duration, and antibiotic use.