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肥胖患者阑尾切除术后的手术并发症:一项单中心三级医疗中心研究。

Surgical Complications Following Appendectomy in Obese Patients: A Single Tertiary Care Center Study.

作者信息

Al Sabr Abdulrahman, Aljohani Abdulrahman, Althoubi Sultan, Al Marzoqi Mohammad, Almutairi Majed, Al Enizy Fahad B, Al Ghuraibi Abdullah, Alsadhan Saud, Alrabah Saud, Boghdadl Sami A

机构信息

Medicine and Surgery, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.

General Surgery, King Abdulaziz Medical City, Riyadh, SAU.

出版信息

Cureus. 2024 Nov 19;16(11):e74033. doi: 10.7759/cureus.74033. eCollection 2024 Nov.

Abstract

Background The escalating global prevalence of obesity raises concerns about its implications for health outcomes. While obesity is acknowledged as a major risk factor for various diseases, its impact on appendicitis and appendectomy outcomes remains less explored. Methods Data on overweight and obese adults aged 18 to 65 treated for appendicitis in King Abdulaziz Medical City in Riyadh, Saudi Arabia were collected retrospectively. The sample included 1,471 patients who underwent laparoscopic appendectomy between January 2015 and January 2022. The sample did not include patients who were outside the age range, underwent conservative or elective treatment, or were pregnant. Data were collected via the National Guard Health Affairs (NGHA's) BESTCare 2.0 system. Statistical analyses were performed using the Statistical Analysis System (SAS) (SAS Institute Inc., Cary, NC) software. Results The final cohort comprised 564 patients, predominantly male (63.65%) with a mean body mass index (BMI) of 27.41. Comorbidities exhibited varying prevalence among BMI groups, with significant differences observed for diabetes, hyperlipidemia, and hypertension. Notably, 86.35% of the patients did not present with complicated appendicitis or encounter complications, irrespective of BMI. The study found comparable rates of diagnostic CT scan usage across BMI categories. Obese patients displayed a statistically significant trend of longer hospital stays, potentially linked to increased comorbidities and being diagnosed at a later age. Conclusion While obesity has been linked to adverse health outcomes, this study found that appendicitis and its surgical management were less influenced by obesity than previously thought. The findings advocate a nuanced approach, acknowledging the impact of obesity on hospitalization trends. This study challenges the assumption that the management of appendicitis in the obese population needs a more tailored intervention.

摘要

背景 全球肥胖患病率不断攀升,引发了人们对其对健康结果影响的担忧。虽然肥胖被认为是多种疾病的主要危险因素,但其对阑尾炎及阑尾切除术后结果的影响仍有待深入研究。方法 回顾性收集沙特阿拉伯利雅得阿卜杜勒阿齐兹国王医疗城18至65岁因阑尾炎接受治疗的超重和肥胖成年人的数据。样本包括2015年1月至2022年1月期间接受腹腔镜阑尾切除术的1471例患者。样本不包括年龄范围之外、接受保守或择期治疗或怀孕的患者。数据通过国民警卫队卫生事务(NGHA)的BESTCare 2.0系统收集。使用统计分析系统(SAS)(SAS Institute Inc.,北卡罗来纳州卡里)软件进行统计分析。结果 最终队列包括564例患者,以男性为主(63.65%),平均体重指数(BMI)为27.41。合并症在不同BMI组中的患病率各不相同,糖尿病、高脂血症和高血压存在显著差异。值得注意的是,无论BMI如何,86.35%的患者未出现复杂性阑尾炎或遭遇并发症。该研究发现不同BMI类别中诊断性CT扫描的使用率相当。肥胖患者的住院时间在统计学上有显著延长的趋势,这可能与合并症增加及诊断时年龄较大有关。结论 虽然肥胖与不良健康结果相关,但本研究发现阑尾炎及其手术治疗受肥胖的影响比先前认为的要小。研究结果提倡采取细致入微的方法,认识到肥胖对住院趋势的影响。本研究挑战了肥胖人群阑尾炎管理需要更具针对性干预的假设。

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