Tracheotomy Outcomes in Super Obese Patients

Area of Science:

• Surgical outcomes
• Critical care medicine
• Obesity medicine

Background:

• Understanding outcomes for super obese patients undergoing tracheotomy is crucial for informed patient and family counseling.
• Super obesity is defined as a body mass index (BMI) greater than 50.

Purpose of the Study:

• To evaluate outcomes, complications, and mortality associated with tracheotomy in super obese patients (BMI > 50).
• To compare these outcomes against a control group of obese patients (BMI 30-50).

Main Methods:

• Retrospective review of billing records from a tertiary academic medical center (November 2010 - June 2013).
• Analysis of medical records to identify patient characteristics, including BMI, comorbidities, and surgical techniques.
• Comparison between super obese (BMI > 50) and obese (BMI 30-50) patient groups.

Main Results:

• Super obese patients (n=31) had a higher rate of tracheostomy dependence at discharge (81%) compared to obese patients (n=34) (52%).
• Ventilator dependence at discharge was also higher in the super obese group (23%) versus the obese group (13%).
• The super obese group experienced a higher overall complication rate (19%) than the obese group (6%), while in-hospital mortality was similar.

Conclusions:

• Tracheotomy is a safe and effective airway management strategy for super obese patients.
• Critically ill super obese patients undergoing tracheotomy have a significant likelihood of remaining tracheostomy or ventilator-dependent upon discharge.