The influence of underweight and obesity on the diagnosis and treatment of appendicitis in children
Purpose The impact of lower body mass index (BMI) on appendicitis has never been addressed. We investigated whether different BMIs affect the diagnosis and treatment of appendicitis in children. Methods The correlation between BMI and diagnosis accuracy and treatment quality was evaluated by retrosp...
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| Veröffentlicht in: | International journal of colorectal disease 2016-08, Vol.31 (8), p.1467-1473 |
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| creator | Timmerman, Marjolijn E. W. Groen, Henk Heineman, Erik Broens, Paul M. A. |
| description | Purpose
The impact of lower body mass index (BMI) on appendicitis has never been addressed. We investigated whether different BMIs affect the diagnosis and treatment of appendicitis in children.
Methods
The correlation between BMI and diagnosis accuracy and treatment quality was evaluated by retrospective analysis of 457 children diagnosed with appendicitis. Based on BMI percentiles, patients were classified as either underweight (
n
= 36), normal weight (
n
= 346), overweight (
n
= 59), or obese (
n
= 16). Diagnosis accuracy was measured by negative appendectomy rate, perforation rate, and number of consultations. Treatment quality was measured by complication rate and length of hospital stay.
Results
Underweight patients had the highest negative appendectomy (OR 3.00,
P
= 0.008) and complication (OR 2.75,
P
= 0.041) rate. BMI did not influence perforation rate or number of consultations. Both underweight and obese patients stayed in the hospital longer than normal weight patients (regression coefficient 2.34,
P
= 0.001, and regression coefficient 9.40,
P
|
| doi_str_mv | 10.1007/s00384-016-2614-6 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4947471</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A714488804</galeid><sourcerecordid>A714488804</sourcerecordid><originalsourceid>FETCH-LOGICAL-c570t-a9eae2abd4690d6d13a131b9c1609a57d1256dd97baa8f26cb95327d505dd9a23</originalsourceid><addsrcrecordid>eNqNkkFvFSEUhYnR2NfqD3BjJnHjZiqXYYDZmDSNWpMmbuqaMHBnHs08eMKMTf-9jK_W1mhiWBC43zm5XA4hr4CeAqXyXaa0UbymIGomgNfiCdkAb1gNTLCnZENBdjV0rToixzlf03IWkj8nR0w2VBbZhtirLVY-DNOCwWIVh2oJDtMN-nE7Vya4KvaY_XxbxVDNhXXejCFmn38W54Rm3mGYV6XZ7zE4b_1cqj5UdusnlzC8IM8GM2V8ebefkK8fP1ydX9SXXz59Pj-7rG0r6VybDg0y0zsuOuqEg8ZAA31nQdDOtNIBa4VzneyNUQMTtu_ahknX0rbcGtackPcH3_3S79DZ0lYyk94nvzPpVkfj9eNK8Fs9xu-ad1xyCcXg7Z1Bit8WzLPe-WxxmkzAuGQNiirRyFbR_0FbrqQQoqBv_kCv45JCmUShAEAw0bDf1Ggm1OVHYmnRrqb6TALnSinKC3X6F6oshztvY8DBl_tHAjgIbIo5JxzuxwFUryHShxDpkga9hkivDb9-OMd7xa_UFIAdgFxKYcT04EX_dP0BBgbRYQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1811162632</pqid></control><display><type>article</type><title>The influence of underweight and obesity on the diagnosis and treatment of appendicitis in children</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Timmerman, Marjolijn E. W. ; Groen, Henk ; Heineman, Erik ; Broens, Paul M. A.</creator><creatorcontrib>Timmerman, Marjolijn E. W. ; Groen, Henk ; Heineman, Erik ; Broens, Paul M. A.</creatorcontrib><description>Purpose
The impact of lower body mass index (BMI) on appendicitis has never been addressed. We investigated whether different BMIs affect the diagnosis and treatment of appendicitis in children.
Methods
The correlation between BMI and diagnosis accuracy and treatment quality was evaluated by retrospective analysis of 457 children diagnosed with appendicitis. Based on BMI percentiles, patients were classified as either underweight (
n
= 36), normal weight (
n
= 346), overweight (
n
= 59), or obese (
n
= 16). Diagnosis accuracy was measured by negative appendectomy rate, perforation rate, and number of consultations. Treatment quality was measured by complication rate and length of hospital stay.
Results
Underweight patients had the highest negative appendectomy (OR 3.00,
P
= 0.008) and complication (OR 2.75,
P
= 0.041) rate. BMI did not influence perforation rate or number of consultations. Both underweight and obese patients stayed in the hospital longer than normal weight patients (regression coefficient 2.34,
P
= 0.001, and regression coefficient 9.40,
P
< 0.001, respectively).
Furthermore, in obese patients, the hospital stay after open appendectomy was prolonged compared to laparoscopic appendectomy (
P
< 0.001). No such differences were observed in patients with lower BMI.
Conclusions
Underweight children are misdiagnosed more often, stay in hospital longer, and experience more postoperative complications than children of normal weight. Obesity is associated with longer hospital stays. Laparoscopic appendectomy might shorten the length of hospital stays in these patients. We conclude that in addition to obesity, underweight should also be considered a risk factor for children with appendicitis.</description><identifier>ISSN: 0179-1958</identifier><identifier>EISSN: 1432-1262</identifier><identifier>DOI: 10.1007/s00384-016-2614-6</identifier><identifier>PMID: 27307016</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adolescent ; Appendectomy ; Appendicitis ; Appendicitis - complications ; Appendicitis - diagnosis ; Appendicitis - surgery ; Body Mass Index ; Care and treatment ; Child ; Child, Preschool ; Children ; Children's furniture ; Gastroenterology ; Health aspects ; Hepatology ; Humans ; Internal Medicine ; Laparoscopy ; Length of Stay ; Medicine ; Medicine & Public Health ; Obesity - complications ; Obesity in children ; Original ; Original Article ; Proctology ; Risk factors ; Surgery ; Thinness - complications ; Treatment Outcome</subject><ispartof>International journal of colorectal disease, 2016-08, Vol.31 (8), p.1467-1473</ispartof><rights>The Author(s) 2016</rights><rights>COPYRIGHT 2016 Springer</rights><rights>Springer-Verlag Berlin Heidelberg 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c570t-a9eae2abd4690d6d13a131b9c1609a57d1256dd97baa8f26cb95327d505dd9a23</citedby><cites>FETCH-LOGICAL-c570t-a9eae2abd4690d6d13a131b9c1609a57d1256dd97baa8f26cb95327d505dd9a23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00384-016-2614-6$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00384-016-2614-6$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,315,781,785,886,27929,27930,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27307016$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Timmerman, Marjolijn E. W.</creatorcontrib><creatorcontrib>Groen, Henk</creatorcontrib><creatorcontrib>Heineman, Erik</creatorcontrib><creatorcontrib>Broens, Paul M. A.</creatorcontrib><title>The influence of underweight and obesity on the diagnosis and treatment of appendicitis in children</title><title>International journal of colorectal disease</title><addtitle>Int J Colorectal Dis</addtitle><addtitle>Int J Colorectal Dis</addtitle><description>Purpose
The impact of lower body mass index (BMI) on appendicitis has never been addressed. We investigated whether different BMIs affect the diagnosis and treatment of appendicitis in children.
Methods
The correlation between BMI and diagnosis accuracy and treatment quality was evaluated by retrospective analysis of 457 children diagnosed with appendicitis. Based on BMI percentiles, patients were classified as either underweight (
n
= 36), normal weight (
n
= 346), overweight (
n
= 59), or obese (
n
= 16). Diagnosis accuracy was measured by negative appendectomy rate, perforation rate, and number of consultations. Treatment quality was measured by complication rate and length of hospital stay.
Results
Underweight patients had the highest negative appendectomy (OR 3.00,
P
= 0.008) and complication (OR 2.75,
P
= 0.041) rate. BMI did not influence perforation rate or number of consultations. Both underweight and obese patients stayed in the hospital longer than normal weight patients (regression coefficient 2.34,
P
= 0.001, and regression coefficient 9.40,
P
< 0.001, respectively).
Furthermore, in obese patients, the hospital stay after open appendectomy was prolonged compared to laparoscopic appendectomy (
P
< 0.001). No such differences were observed in patients with lower BMI.
Conclusions
Underweight children are misdiagnosed more often, stay in hospital longer, and experience more postoperative complications than children of normal weight. Obesity is associated with longer hospital stays. Laparoscopic appendectomy might shorten the length of hospital stays in these patients. We conclude that in addition to obesity, underweight should also be considered a risk factor for children with appendicitis.</description><subject>Adolescent</subject><subject>Appendectomy</subject><subject>Appendicitis</subject><subject>Appendicitis - complications</subject><subject>Appendicitis - diagnosis</subject><subject>Appendicitis - surgery</subject><subject>Body Mass Index</subject><subject>Care and treatment</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Children's furniture</subject><subject>Gastroenterology</subject><subject>Health aspects</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Laparoscopy</subject><subject>Length of Stay</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Obesity - complications</subject><subject>Obesity in children</subject><subject>Original</subject><subject>Original Article</subject><subject>Proctology</subject><subject>Risk factors</subject><subject>Surgery</subject><subject>Thinness - complications</subject><subject>Treatment Outcome</subject><issn>0179-1958</issn><issn>1432-1262</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkkFvFSEUhYnR2NfqD3BjJnHjZiqXYYDZmDSNWpMmbuqaMHBnHs08eMKMTf-9jK_W1mhiWBC43zm5XA4hr4CeAqXyXaa0UbymIGomgNfiCdkAb1gNTLCnZENBdjV0rToixzlf03IWkj8nR0w2VBbZhtirLVY-DNOCwWIVh2oJDtMN-nE7Vya4KvaY_XxbxVDNhXXejCFmn38W54Rm3mGYV6XZ7zE4b_1cqj5UdusnlzC8IM8GM2V8ebefkK8fP1ydX9SXXz59Pj-7rG0r6VybDg0y0zsuOuqEg8ZAA31nQdDOtNIBa4VzneyNUQMTtu_ahknX0rbcGtackPcH3_3S79DZ0lYyk94nvzPpVkfj9eNK8Fs9xu-ad1xyCcXg7Z1Bit8WzLPe-WxxmkzAuGQNiirRyFbR_0FbrqQQoqBv_kCv45JCmUShAEAw0bDf1Ggm1OVHYmnRrqb6TALnSinKC3X6F6oshztvY8DBl_tHAjgIbIo5JxzuxwFUryHShxDpkga9hkivDb9-OMd7xa_UFIAdgFxKYcT04EX_dP0BBgbRYQ</recordid><startdate>20160801</startdate><enddate>20160801</enddate><creator>Timmerman, Marjolijn E. W.</creator><creator>Groen, Henk</creator><creator>Heineman, Erik</creator><creator>Broens, Paul M. A.</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20160801</creationdate><title>The influence of underweight and obesity on the diagnosis and treatment of appendicitis in children</title><author>Timmerman, Marjolijn E. W. ; Groen, Henk ; Heineman, Erik ; Broens, Paul M. A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c570t-a9eae2abd4690d6d13a131b9c1609a57d1256dd97baa8f26cb95327d505dd9a23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adolescent</topic><topic>Appendectomy</topic><topic>Appendicitis</topic><topic>Appendicitis - complications</topic><topic>Appendicitis - diagnosis</topic><topic>Appendicitis - surgery</topic><topic>Body Mass Index</topic><topic>Care and treatment</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Children's furniture</topic><topic>Gastroenterology</topic><topic>Health aspects</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Laparoscopy</topic><topic>Length of Stay</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Obesity - complications</topic><topic>Obesity in children</topic><topic>Original</topic><topic>Original Article</topic><topic>Proctology</topic><topic>Risk factors</topic><topic>Surgery</topic><topic>Thinness - complications</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Timmerman, Marjolijn E. W.</creatorcontrib><creatorcontrib>Groen, Henk</creatorcontrib><creatorcontrib>Heineman, Erik</creatorcontrib><creatorcontrib>Broens, Paul M. A.</creatorcontrib><collection>Springer Nature OA/Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International journal of colorectal disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Timmerman, Marjolijn E. W.</au><au>Groen, Henk</au><au>Heineman, Erik</au><au>Broens, Paul M. A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The influence of underweight and obesity on the diagnosis and treatment of appendicitis in children</atitle><jtitle>International journal of colorectal disease</jtitle><stitle>Int J Colorectal Dis</stitle><addtitle>Int J Colorectal Dis</addtitle><date>2016-08-01</date><risdate>2016</risdate><volume>31</volume><issue>8</issue><spage>1467</spage><epage>1473</epage><pages>1467-1473</pages><issn>0179-1958</issn><eissn>1432-1262</eissn><abstract>Purpose
The impact of lower body mass index (BMI) on appendicitis has never been addressed. We investigated whether different BMIs affect the diagnosis and treatment of appendicitis in children.
Methods
The correlation between BMI and diagnosis accuracy and treatment quality was evaluated by retrospective analysis of 457 children diagnosed with appendicitis. Based on BMI percentiles, patients were classified as either underweight (
n
= 36), normal weight (
n
= 346), overweight (
n
= 59), or obese (
n
= 16). Diagnosis accuracy was measured by negative appendectomy rate, perforation rate, and number of consultations. Treatment quality was measured by complication rate and length of hospital stay.
Results
Underweight patients had the highest negative appendectomy (OR 3.00,
P
= 0.008) and complication (OR 2.75,
P
= 0.041) rate. BMI did not influence perforation rate or number of consultations. Both underweight and obese patients stayed in the hospital longer than normal weight patients (regression coefficient 2.34,
P
= 0.001, and regression coefficient 9.40,
P
< 0.001, respectively).
Furthermore, in obese patients, the hospital stay after open appendectomy was prolonged compared to laparoscopic appendectomy (
P
< 0.001). No such differences were observed in patients with lower BMI.
Conclusions
Underweight children are misdiagnosed more often, stay in hospital longer, and experience more postoperative complications than children of normal weight. Obesity is associated with longer hospital stays. Laparoscopic appendectomy might shorten the length of hospital stays in these patients. We conclude that in addition to obesity, underweight should also be considered a risk factor for children with appendicitis.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>27307016</pmid><doi>10.1007/s00384-016-2614-6</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0179-1958 |
| ispartof | International journal of colorectal disease, 2016-08, Vol.31 (8), p.1467-1473 |
| issn | 0179-1958 1432-1262 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4947471 |
| source | MEDLINE; SpringerNature Journals |
| subjects | Adolescent Appendectomy Appendicitis Appendicitis - complications Appendicitis - diagnosis Appendicitis - surgery Body Mass Index Care and treatment Child Child, Preschool Children Children's furniture Gastroenterology Health aspects Hepatology Humans Internal Medicine Laparoscopy Length of Stay Medicine Medicine & Public Health Obesity - complications Obesity in children Original Original Article Proctology Risk factors Surgery Thinness - complications Treatment Outcome |
| title | The influence of underweight and obesity on the diagnosis and treatment of appendicitis in children |
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