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. 2014 May;124(5):1118-22.
doi: 10.1002/lary.24347. Epub 2014 Mar 1.

Predictors of clinical outcome after tracheotomy in critically ill obese patients

J Kenneth Byrd  1 , Viran J Ranasinghe, Kristine E Day, Bethany J Wolf, Eric J Lentsch
Affiliations

Predictors of clinical outcome after tracheotomy in critically ill obese patients

J Kenneth Byrd et al. Laryngoscope. 2014 May.

Abstract

Objectives/hypothesis: To identify patient factors associated with outcomes in critically ill obese patients requiring tracheotomy.

Study design: Single-institution, retrospective cohort study.

Methods: Charts were reviewed for inpatients admitted to an intensive care unit from 2007 to 2010 with International Classification of Diseases, 9th Revision codes of obesity or morbid obesity and tracheotomy. Variables collected in the dataset include subject age, ethnicity, gender, body mass index, tracheotomy type, patient outcome, chief diagnosis, and medical comorbid conditions. The primary outcomes of interest were tracheotomy type and patient outcome at the time of hospital discharge. Logistic regression models were developed for the probability of each patient outcome using univariate and multivariate models.

Results: One hundred two patients met inclusion criteria. The most common outcome was tracheostomy dependence (49%). Increased mortality was independently significantly associated with pulmonary hypertension (P = .019) and African American ethnicity (P = .045). Increased tracheostomy dependence was significantly associated with obstructive sleep apnea (P = .030). Increased decannulation was significantly associated with percutaneous tracheotomy (P = .016) and Caucasian ethnicity (P < .001).

Conclusions: Obese patients in the intensive care unit who undergo tracheotomy have a high likelihood of remaining tracheostomy dependent at the time of discharge from the hospital. The factors most commonly found to be significantly associated with poor outcomes were open tracheotomy, African American ethnicity, obstructive sleep apnea, and pulmonary hypertension.

Keywords: Obesity; critically ill; decannulation; intensive care unit; morbid obesity; mortality; outcome; tracheotomy.

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Conflict of interest statement

The authors have no other funding, financial relationships, or conflicts of interest to disclose.

References

    1. Executive summary of the clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. Arch Intern Med. 1998;158:1855–1867. - PubMed
    1. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity in the United States, 2009–2010. NCHS Data Brief. 2012;(82):1–8. - PubMed
    1. Harris AT, Morell D, Bajaj Y, Martin-Hirsch DP. A discussion of airway and respiratory complications along with general considerations in obese patients. Int J Clin Pract. 2010;64:802–806. - PubMed
    1. Flegal KM, Kit BK, Orpana H, Graubard BI. Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA. 2013;309:71–82. - PMC - PubMed
    1. Stewart ST, Cutler DM, Rosen AB. Forecasting the effects of obesity and smoking on U.S. life expectancy. N Engl J Med. 2009;361:2252–2260. - PMC - PubMed

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