Lam Samuel H F, Kerwin Christopher, Konicki P John, Goodwine Diana, Lambert Michael J
Advocate Christ Medical Center, Department of Emergency Medicine, Oak Lawn, Illinois.
West J Emerg Med. 2016 Jul;17(4):454-9. doi: 10.5811/westjem.2016.5.29681. Epub 2016 Jun 29.
The objective of this study was to determine whether there is a relationship between body mass index (BMI) and success or accuracy rate of beside ultrasound (BUS) for the diagnosis of appendicitis.
Patients four years of age and older presenting to the emergency department with suspected appendicitis were eligible. Enrollment was by convenience sampling. After informed consent, BUS was performed by trained emergency physicians who had undergone a minimum of one-hour didactic training on the use of BUS to diagnose appendicitis. We ascertained subject outcomes by a combination of medical record review and telephone follow up. Calculated BMI for adults and children were divided into four categories (underweight, normal, overweight, obese) according to Centers for Disease Control and Prevention classifications.
A total of 125 subjects consented for the study, and 116 of them had adequate image data for final analysis. Seventy (60%) of the subjects were children. Prevalence of appendicitis was 39%. Fifty-two (45%) of the BUS studies were diagnostic (successful). Overall accuracy rate was 75%. Analysis by chi-square test or Mann-Whitney U test did not find any significant correlation between BMI category and BUS success. Similarly, there was no significant correlation between BMI category and BUS accuracy. The same conclusion was reached when children and adults were analyzed separately, or when subjects were dichotomized into underweight/normal and overweight/obese categories.
BMI category alone is a poor predictor of appendix BUS success or accuracy.
本研究的目的是确定体重指数（BMI）与床旁超声（BUS）诊断阑尾炎的成功率或准确率之间是否存在关联。
4岁及以上因疑似阑尾炎就诊于急诊科的患者符合入选条件。采用方便抽样法进行入组。在获得知情同意后，由经过培训的急诊医生进行BUS检查，这些医生接受了至少1小时关于使用BUS诊断阑尾炎的理论培训。我们通过病历审查和电话随访相结合的方式确定受试者的结局。根据疾病控制与预防中心的分类，将成人和儿童计算出的BMI分为四类（体重过轻、正常、超重、肥胖）。
共有125名受试者同意参与本研究，其中116名有足够的图像数据用于最终分析。70名（60%）受试者为儿童。阑尾炎的患病率为39%。52项（45%）BUS检查具有诊断价值（成功）。总体准确率为75%。通过卡方检验或曼-惠特尼U检验分析，未发现BMI类别与BUS诊断成功之间存在任何显著相关性。同样，BMI类别与BUS准确率之间也无显著相关性。分别对儿童和成人进行分析，或将受试者分为体重过轻/正常和超重/肥胖两类时，得出了相同的结论。
仅BMI类别不能很好地预测BUS诊断阑尾炎的成功与否或准确率。
