An observational study on lifestyle and environmental risk factors in patients with acute appendicitis
Toon Peeters,
Bert Houben,
Peter Cools,
Yati Thys,
Valentino D'Onofrio,
Sandrina Martens,
Martin Jaeger,
Marije Doppenberg-Oosting,
Mihai G. Netea,
Inge C. Gyssens
Affiliations
Toon Peeters
Department of Infectious Diseases and Immunity, Jessa Hospital, 3500 Hasselt, Belgium; Department of Experimental Pathology, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium; Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands; Radboudumc Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, the Netherlands; Corresponding author. Hasselt University, Campus Diepenbeek, Agoralaan Gebouw C, BE 3590 Diepenbeek, Belgium.
Bert Houben
Department of Abdominal and Oncological Surgery, Jessa Hospital, 3500 Hasselt, Belgium
Peter Cools
Department of Abdominal Surgery, GZA Hospital, Antwerp, Belgium
Yati Thys
Department of Infectious Diseases and Immunity, Jessa Hospital, 3500 Hasselt, Belgium; Department of Experimental Pathology, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium
Valentino D'Onofrio
Department of Infectious Diseases and Immunity, Jessa Hospital, 3500 Hasselt, Belgium; Department of Experimental Pathology, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium; Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands; Radboudumc Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, the Netherlands
Sandrina Martens
Department of Experimental Pathology, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium
Martin Jaeger
Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands; Radboudumc Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, the Netherlands; Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
Marije Doppenberg-Oosting
Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands
Mihai G. Netea
Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands; Radboudumc Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, the Netherlands
Inge C. Gyssens
Department of Infectious Diseases and Immunity, Jessa Hospital, 3500 Hasselt, Belgium; Department of Experimental Pathology, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium; Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands; Radboudumc Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, the Netherlands
Purpose: Acute appendicitis is a common abdominal emergency worldwide. This study aimed at characterizing environmental risk factors influencing the development and severity of acute appendicitis. Methods: Patients from a Belgian acute appendicitis cohort (n = 374) and healthy controls from the 500 functional genomics (500FG) cohort (n = 513) were compared. Individuals with a history of appendectomy (n = 1067) and without a history of appendectomy (n = 8656) were available from the Nijmegen Biomedical Study (NBS). Questionnaires on demographics, lifestyle and environment were available. Binary logistic regression was used for prediction models. Results: Fifteen risk factors for developing acute appendicitis were identified. Binary logistic regression showed that 7 were independent risk factors: family history of acute appendicitis, having grown up in a rural environment, having a lower education, probiotic use as well as antibiotic use increased the risk of developing appendicitis. Fruit and fiber-rich vegetable consumption decreased the risk. Findings on vegetable consumption, smoking and level of education were replicated in the NBS population. Independent risk factors for complicated appendicitis were being male, higher age, and a delay to diagnosis of more than 48 h. Conclusions: Environmental exposures influence the risk of developing appendicitis. Further research into these factors is needed.
