ผลของภาวะอ้วนที่มีต่อค่าคะแนน Alvarado ในผู้ป่วยโรคไส้ติ่งอักเสบ และ พารามิเตอร์ที่สำคัญในผู้ป่วยภาวะอ้วนที่มีผลต่อการวินิจฉัยไส้ติ่งอักเสบ

Orrawee Loatrakul

Authors

Orrawee Loatrakul Nakhonpathom Hospital

Keywords:

Alvarado score, Obesity, Appendicitis

Abstract

Objective: To study whether obesity has affected Alvarado score in the confirmed appendicitis patients who underwent appendectomy and to identify the significant predictive parameters from Alvarado score in the obese patients

Methods: This retrospective cohort study was conducted in the Department of Surgery from the electronic medical records of the confirmed appendicitis in adult patients of Nakhonpathom Hospital from January 2021 to December 2024. The sample sizes of the obese were 24 patients and 152 patients for the non-obese. Alvarado score, types of appendicitis, complications, need for CT scan, durations of symptom, operative time, and length of stay were compared.

Results: The mean Alvarado score was 6.71 ± 1.71 in obese patients and 7.13 ± 1.68 in non-obese patients, with no statistically significant different (p-value = .255). Obesity was not associated with the need of CT scan and complicated appendicitis, including operative time and length of stay. Neutrophilia (neutrophil > 75%) was significantly associated with appendicitis in the obese (p-value .004). Furthermore, Alvarado score of obese patients with complicated appendicitis, 8.5 ± 1.0, was statistically and significantly different from those with uncomplicated appendicitis, 6.35 ± 1.6 (p-value = .018).

Conclusion: Obesity does not affect Alvarado score, nor associated with the need for CT scan and severity of appendicitis. For obese group, the patients with neutrophilia are significantly associated with appendicitis statistically. Furthermore, the patients from this group with higher Alvarado score implicate a chance of complicated appendicitis while lower score with RLQ and neutrophilia still carry the risk of uncomplicated appendicitis. CT scan should be carried to confirm diagnosis if clinical symptoms of appendicitis is suspicious.

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เจษฎา เวชวิทยานุกูล. ค่าคะแนนอัลวาราโดที่เหมาะสมและปัจจัยที่มีผลต่ออัตราการผ่าตัดไส้ติ่งที่ไม่พบพยาธิ สภาพ. วารสารโรงพยาบาลนครพนม. 2022;9(1):1–18.