Outcomes of perforated appendicitis in obese and nonobese children

“…A single-institution study of 282 children requiring appendectomy found that obese children required longer operative times, longer hospital stays, and those with perforated appendicitis had increased risk of postoperative infections[18]. A small meta-analysis of 3 studies analyzed 220 pediatric patients undergoing laparoscopic appendectomy for perforated appendicitis, and identified that obese patients had longer operative times and increased abscess rate[19]. A study of 312 children requiring laparoscopic cholecystectomy, however, did not find any significant differences in outcomes with obesity[20].…”

Section: 1 Backgroundmentioning

confidence: 99%

Effect of body mass index percentile on pediatric gastrointestinal surgery outcomes

Witt

Goldin

Vavilala

et al. 2016

Journal of Pediatric Surgery

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Background/Purpose Pediatric obesity is an important public health concern, yet its effect on surgical outcomes is poorly understood. The purpose of this study was to determine if age and gender-specific body mass index (BMI) percentile influences complications and hospital resource utilization following pediatric gastrointestinal surgeries. Methods Patients aged age ≥2 to <18 years who underwent appendectomy or other gastrointestinal operations were identified in the 2012 - 2013 Pediatric National Surgical Quality Improvement Program datasets. Age- and gender-specific pediatric BMI percentiles were calculated. Patients who underwent appendectomy (n=9,606) and those undergoing all other intestinal operations (n=2,664) were evaluated as separate cohorts. Results In the appendectomy cohort, frequency of any complication increased with BMI category (normal-weight 4.5%, overweight 5.3%, obese 5.7%, morbidly obese 7.3%, overall 5.0%, p = 0.014). In multivariable analysis, there was a quadratic association between BMI percentile and increased frequency of superficial incisional infection, unplanned tracheal intubation, and longer operative duration. In the intestinal surgery cohort, BMI percentile was not a predictor of any individual complication or any measure of hospital utilization. Conclusions Age- and gender-specific BMI percentile was associated with increased risk of complications and longer operative duration in patients undergoing appendectomy but not other intestinal operations.

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“…Similarly, there is some literature to suggest that obese individuals may also be at increased risk for IAA formation [23], although there are conflicting data in this regard [21,22]. Additional research is needed to better understand how these disparities arise and to better understand what role a person's age, gender, and insurance status may have on rates of postoperative IAA formation.…”

Section: Summary/discussionmentioning

confidence: 99%

“…Obesity has been associated with a predisposition for perforated appendicitis, but this has not always translated to an increased risk of postoperative IAA [21,22]. Controversy exists, however, because other investigators have demonstrated an increased risk of postoperative IAA formation in obese children, as high as 35% [23], underscoring the need for additional research in this unique patient population.…”

Section: Obesitymentioning

confidence: 99%