The association between body mass index and the severity of cholecystitis

BackgroundSevere cholecystitis occurs more frequently in males, and the cause of this discrepancy is unknown.MethodsA retrospective study was performed on 910 consecutive patients who underwent laparoscopic cholecystectomy for cholecystitis. The patients were classified according to body mass index (BMI) as obese (n = 354, BMI ≥25 kg/m2) and nonobese (n = 556; BMI <25).ResultsIn males, there was a significant negative correlation between the BMI and the severity of cholecystitis; the proportion of complicated acute cholecystitis was higher in the nonobese patients (21.5%) compared with the obese patients (8.1%) (P = .007) but not for the females (P = .80). A BMI <25 (odds ratio [OR] = 1.92, P = .01), advanced age (OR = 2.52, P < .001), male sex (OR = 1.74, P = .022), and leukocytosis (OR = 1.92, P = .024) were independent predictors for the development of complicated acute cholecystitis.ConclusionThere is a negative association between BMI and the inflammation severity of cholecystitis in males, which resulted in a higher incidence of severe cholecystitis in the nonobese male patients.