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Multicenter Study
. 2024 Nov;134(11):4674-4681.
doi: 10.1002/lary.31586. Epub 2024 Jun 19.

Impact of Obesity on Timing of Tracheotomy: A Multi-institutional Retrospective Study

Andrew Yousef  1 , Shady I Soliman  1 , Isaac Solomon  1 , Bharat A Panuganti  2 , David O Francis  3 , John Pang  4 , Dasha Klebaner  1 , Alicia Asturias  1 , Ali Alattar  1 , Samuel Wood  1 , Morgan Terry  5 , Paul C Bryson  5 , Courtney B Tipton  6 , Elise E Zhao  6 , Ashli O'Rourke  6 , Chloe Santa Maria  7 , David R Grimm  7 , C K Sung  7 , Wilson P Lao  8 , Jordan M Thompson  8 , Brianna K Crawley  8 , Sarah Rosen  3 , Anna Berezovsky  9 , Robbi Kupfer  9 , Theresa B Hennesy  10 , Matthew Clary  10 , Ian T Joseph  11 , Kamron Sarhadi  11 , Maggie Kuhn  11 , Yassmeen Abdel-Aty  12 , Maeve M Kennedy  12 , David G Lott  12 , Philip A Weissbrod  1
Affiliations
Multicenter Study

Impact of Obesity on Timing of Tracheotomy: A Multi-institutional Retrospective Study

Andrew Yousef et al. Laryngoscope. 2024 Nov.

Abstract

Objective: To examine the impact of increased body mass index (BMI) on (1) tracheotomy timing and (2) short-term surgical complications requiring a return to the operating room and 30-day mortality utilizing data from the Multi-Institutional Study on Tracheotomy (MIST).

Methods: A retrospective analysis of patients from the MIST database who underwent surgical or percutaneous tracheotomy between 2013 and 2016 at eight institutions was completed. Unadjusted and adjusted logistic regression analyses were used to assess the impact of obesity on tracheotomy timing and complications.

Results: Among the 3369 patients who underwent tracheotomy, 41.0% were obese and 21.6% were morbidly obese. BMI was associated with higher rates of prolonged intubation prior to tracheotomy accounting for comorbidities, indication for tracheotomy, institution, and type of tracheostomy (p = 0.001). Morbidly obese patients (BMI ≥35 kg/m2) experienced a longer duration of intubation compared with patients with a normal BMI (median days intubated [IQR 25%-75%]: 11.0 days [7-17 days] versus 9.0 days [5-14 days]; p < 0.001) but did not have statistically higher rates of return to the operating room within 30 days (p = 0.12) or mortality (p = 0.90) on multivariable analysis. This same finding of prolonged intubation was not seen in overweight, nonobese patients when compared with normal BMI patients (median days intubated [IQR 25%-75%]: 10.0 days [6-15 days] versus 10.0 days [6-15 days]; p = 0.36).

Conclusion: BMI was associated with increased duration of intubation prior to tracheotomy. Although morbidly obese patients had a longer duration of intubation, there were no differences in return to the operating room or mortality within 30 days.

Level of evidence: 3 Laryngoscope, 134:4674-4681, 2024.

Keywords: obesity; prolonged intubation; short‐term complications; tracheotomy.

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Conflict of interest statement

Conflicts of Interest: None of the authors of this manuscript have any conflicts of interest to report.

Figures

Figure 1:
Figure 1:
A) Days intubated prior to tracheotomy stratified by Obesity Classification. B) Percent requiring return to operating room within 30 days by Obesity Classification.
See this image and copyright information in PMC

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