The Effect of Body Mass Index on Patients' Length of Stay Post-appendectomy.

Background And Aim: Appendicitis is defined as the appendix's inflammation, which requires an appendectomy for treatment. Obesity is one of the risk factors for post-surgical complications in appendicitis. This study aimed to explore obesity's influence on hospital length of stay among patients with appendicitis in Taif, Saudi Arabia.

Methods: The study subjects consisted of both children and adults with appendicitis who were admitted to the hospital during 2021 and 2022. The patients were divided into three groups according to body mass index (BMI) following the WHO criteria: normal weight (BMI = 18.5-24.9 kg/m), overweight (BMI = 25-29.9 kg/m), and obesity (BMI ≥10 kg/m). Data collection was conducted retrospectively by reviewing the medical records of patients diagnosed with appendicitis. The data collection included demographic characteristics of the patients, clinical presentation data, examination data, findings of the diagnostic approaches, management data, and complications after surgery (mainly intra-abdominal abscess formation). Prior to conducting the study, ethical approval was obtained from the Institutional Review Board of the Saudi Ministry of Health.

Results: The study included 238 patients who were diagnosed with appendicitis with an age range from 4 to 74 years and a mean (SD) age of 20.24 years (12.69). Based on BMI categories, 174 patients (73.1%) were classified as non-obese (BMI < 25), 53 patients (22.3%) were overweight (BMI 25-29.9), and 11 patients (4.6%) were obese (BMI ≥ 30). Most patients were presented with fever (51.7%), anorexia (72.7%), and pain in the right lower quadrant (70.2%). According to blood pressure, the mean (SD) of systolic and diastolic blood pressure was 117.8 (14.14) and 71.03 (9.89), respectively. All cases underwent abdominal ultrasound; non-visualization of the appendix was the most common finding observed (80.3%). Appendicitis was managed among most patients with appendectomy (89.5%), and open appendectomy was the most frequent surgery performed (73.2%). The mean of hospital length of stay was 1.64 (0.73) days. There was no significant correlation between patients' BMI and hospital length of stay (p = 0.429). The mean hospital length of stay of females (1.76) was higher than that of males (1.53) (p = 0.003). Moreover, a statistically significant mean difference was observed in hospital length of stay between patients managed conservatively (1.96) and those who underwent operative management (1.60 days) (p < 0.001).

Conclusion: This study provides insights into the effect of obesity on patients with appendicitis who underwent an appendectomy in Taif, Saudi Arabia. The study found that obesity was not a risk factor for a prolonged hospital length of stay after appendectomy. Further studies with larger sample sizes are needed to explore other factors that may influence the outcomes of appendectomy in patients with appendicitis, such as the impact of obesity on long-term complications and recurrence rates.