title: Obesity should not influence the management of appendicitis.
abstract: BACKGROUND
  Obesity implies an adverse effect on outcome after appendectomy. This study aimed to determine whether obese patients with appendicitis should be managed differently than nonobese patients.
  
  
  METHODS
  After appendectomy, all patients were enrolled in a prospective clinical pathway and followed from initial presentation to full outpatient recovery.
  
  
  RESULTS
  In 1 year, 272 adults underwent appendectomy, 55 (22%) of whom were obese. The obese patients were slightly older (35 vs 33 years; p < 0.001). The time to diagnosis (8.5 vs 8.6 h), and the need for computed tomography (CT) scanning (40% vs 49%) was similar in both populations. The obese patients had similar rates of perforation (35% vs 35%) and laparoscopy (47% vs 41%). The median hospital length of stay (LOS) (2 days) and complications, including wound complications (9.1% vs 10.9%) and intraabdominal abscesses (3.6% vs 3.1%), were similar. Subgroup analysis showed a longer LOS for the obese patients with perforation than for the nonobese patients (6 vs 5.5 days; p = 0.036).
  
  
  CONCLUSIONS
  Obese patients had no greater delay in diagnosis, had no greater need for CT scan, gained no additional benefit from laparoscopy, and did not incur significantly worse outcomes after appendectomy except for an increased LOS among those with perforation.
authors.affiliation: Department of Surgery, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048, USA. shirin.towfigh@cshs.org
authors.forename: S
authors.initials: S
authors.lastname: Towfigh
authors.forename: F
authors.initials: F
authors.lastname: Chen
authors.forename: N
authors.initials: N
authors.lastname: Katkhouda
authors.forename: R
authors.initials: R
authors.lastname: Kelso
authors.forename: H
authors.initials: H
authors.lastname: Sohn
authors.forename: T V
authors.initials: TV
authors.lastname: Berne
authors.forename: R J
authors.initials: RJ
authors.lastname: Mason
mesh_terms: D018784:Abdominal Abscess / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D001062:Appendectomy / Q000379:methods / Q000706:statistics & numerical data*; D001064:Appendicitis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D015992:Body Mass Index; D019090:Case Management; D003428:Cross Infection / Q000453:epidemiology; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult