Postoperative Complications in Obese Patients After Tracheostomy

Area of Science:

• Otolaryngology-Head and Neck Surgery
• Surgical Outcomes
• Obesity Research

Background:

• Obesity prevalence is increasing globally.
• Tracheostomy is a common surgical procedure for airway management.
• The impact of varying obesity classes on tracheostomy outcomes requires further investigation.

Purpose of the Study:

• To determine the prevalence of different obesity classes in patients undergoing tracheostomy.
• To compare postoperative complication rates between obese and nonobese patients.
• To identify specific obesity classes associated with increased risks.

Main Methods:

• Retrospective chart review of 387 patients undergoing open tracheostomy (2012-2018).
• Classification of patients by Body Mass Index (BMI) using WHO criteria.
• Analysis of demographic data, comorbidities, surgical details, and postoperative complications.

Main Results:

• Obesity class III (BMI >40) and underweight patients exhibited significantly higher postoperative complication rates (P = .009 and P = .016, respectively).
• Obese patients experienced longer operative times and a higher need for extended-length tracheostomy tubes.
• Malignancy was the primary indication for tracheostomy in nonobese patients, while respiratory failure was more common in obese patients.

Conclusions:

• Class III obesity and underweight status are associated with increased postoperative complications following tracheostomy.
• These findings highlight the importance of considering patient BMI during perioperative counseling and management.
• Further research may explore targeted interventions to mitigate risks in these patient populations.