CC BY 4.0 · Journal of Child Science 2023; 13(01): e96-e103
DOI: 10.1055/s-0043-1770147
Original Article

The Pattern of Nutritional and Inflammatory Parameters in Children with Acute Appendicitis

1   Pediatric Clinical Nutrition Division, Pediatric Department, Faculty of Medicine, Cairo University, Cairo, Egypt
Sherif Kaddah
2   Pediatric Surgery Department, Faculty of Medicine, Cairo University, Cairo, Egypt
Osama M. El-Asheer
3   Pediatric Department, Faculty of Medicine, Assiut University, Assiut, Egypt
Manal Mahmoud
2   Pediatric Surgery Department, Faculty of Medicine, Cairo University, Cairo, Egypt
Ahemd Wishahy
2   Pediatric Surgery Department, Faculty of Medicine, Cairo University, Cairo, Egypt
› Author Affiliations


Background Surgical procedures in children with overweight and obesity have many difficulties due to the high incidence of postoperative complications. This impact on comorbidity has a great interest in various surgical pathologies, such as acute appendicitis, since it is the most frequent surgical emergency in all age and sex groups. However, there are few studies assessing the effect of body mass index (BMI) and other parameters like the Glasgow Prognostic Score (GPS) and C-reactive protein (CRP)/albumin ratio on the course of acute appendicitis in children.

Objectives Identify the impact of BMI and other biomarkers like CRP/albumin ratio and GPS on the clinical course of acute appendicitis in children.

Patients (Materials) and Methods This is a prospective study conducted on 90 pediatric patients of acute appendicitis (30 high BMI and 60 non-high BMI) admitted at Pediatric Surgery Department, Children Hospital Cairo University (CHCU) during the period from March 2022 to September 2022. All patients had preoperative laboratory tests, intraoperative assessment regarding the type of surgery, duration of surgery, and type of appendicitis, then the postoperative assessment.

Results Among the 90 patients, the mean age of participants was 8.74 (2.23) years and there was a male predominance. Frequencies of open surgeries were higher in overweight and obese children (children with high BMI). There was a significant positive correlation between the preoperative CRP/albumin ratio and GPS, and an inverse significant correlation of preoperative albumin with the postoperative hospital length of stay, duration of surgery (operation time), and duration of postoperative fever.

Conclusion There is a significant relationship between the preoperative inflammatory and nutritional markers and postoperative hospital length of stay, duration of surgery (operation time), and duration of postoperative fever.

Authors' Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by H.A.A.I. and M.M. The first draft of the manuscript was written by H.A.A.I. and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.


Health priorities should be directed toward children with higher CRP, CRP/albumin ratio, and GPS in cases of acute appendicitis as they may have higher risks for postoperative hospital length of stay.

Availability of Data and Materials

The data are available with the corresponding author upon a reasonable request

Publication History

Received: 20 March 2023

Accepted: 06 May 2023

Article published online:
27 July 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (

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