Coursey Courtney A, Nelson Rendon C, Moreno Ricardo D, Patel Mayur B, Beam Craig A, Vaslef Steven
Department of Radiology, Duke University Medical Center, Durham, North Carolina, USA.
Am Surg. 2011 Apr;77(4):471-5.
The purpose of our study is to determine whether body mass index (BMI = weight in kg/height in meters(2)) was related to the rate of negative appendectomy in patients who underwent preoperative CT. A surgical database search performed using the procedure code for appendectomy identified 925 patients at least 18 years of age who underwent urgent appendectomy between January 1998 and September 2007. BMI was computed for the 703 of these 925 patients for whom height and weight information was available. Patients were stratified based on body mass index (BMI 15-18.49 = underweight; 18.5-24.9 = normal weight; 25-29.9 = overweight; 30-39.9 = obese; ≥ 40 = morbidly obese). Negative appendectomy rates were computed. Negative appendectomy rates for patients who did and did not undergo preoperative CT were 27 per cent and 50 per cent for underweight patients, 10 per cent and 15 per cent for normal weight patients, 12 per cent and 17 per cent for overweight patients, 7 per cent and 30 per cent for obese patients, and 10 per cent and 100 per cent for morbidly obese patients. The difference in negative appendectomy rates for overweight patients, obese patients, and morbidly obese patients who underwent preoperative CT as compared with patients in the same BMI category who did not undergo preoperative CT was statistically significant (P ≤ 0.001). The negative appendectomy rates for overweight patients, obese patients, and morbidly obese patients who underwent preoperative CT were significantly lower than for patients in these same BMI categories who did not undergo preoperative CT.
我们研究的目的是确定体重指数（BMI=体重（千克）/身高（米）的平方）是否与接受术前CT检查的患者中阴性阑尾切除术的发生率相关。使用阑尾切除术的手术编码在手术数据库中进行检索，确定了1998年1月至2007年9月期间925例至少18岁接受急诊阑尾切除术的患者。这925例患者中有703例可获得身高和体重信息，并计算了其BMI。根据体重指数对患者进行分层（BMI 15-18.49=体重过轻；18.5-24.9=正常体重；25-29.9=超重；30-39.9=肥胖；≥40=病态肥胖）。计算阴性阑尾切除术的发生率。体重过轻的患者中，接受和未接受术前CT检查的患者阴性阑尾切除术发生率分别为27%和50%；正常体重的患者分别为10%和15%；超重的患者分别为12%和17%；肥胖的患者分别为7%和30%；病态肥胖的患者分别为10%和100%。与未接受术前CT检查的同BMI类别患者相比，接受术前CT检查的超重、肥胖和病态肥胖患者的阴性阑尾切除术发生率差异具有统计学意义（P≤0.001）。接受术前CT检查的超重、肥胖和病态肥胖患者的阴性阑尾切除术发生率显著低于未接受术前CT检查的同BMI类别患者。
