Obesity is a predictor of increased morbidity after tracheostomy.

Abstract

The purpose of this study was to analyze the relationship between body mass index (BMI) and 30-day morbidity and mortality risk in patients undergoing tracheostomy using the American College of Surgeons National Quality Improvement Program (ACS-NSQIP). This is a retrospective, cross-sectional, cohort study. Patients were identified with Current Procedural Terminology codes in the ACS-NSQIP database. Patients who underwent tracheostomy from 2005 to 2018 were queried. They were stratified into four BMI classes and matched to normal BMI cohorts. Multivariate logistic regression was used to identify independent predictors for complications, readmissions, and unplanned reoperations within 30days. Among 3784 patients meeting inclusion and exclusion criteria, obesity was shown to be a significant independent risk factor for overall complications (OR 1.439, 95% CI 1.226-1.689, p<0.001), postoperative acute renal failure (OR 10.715, 95% CI 1.213-94.646, p=0.033), and unplanned readmissions (OR 1.702, 95% CI 1.095-2.647, p=0.018). A significantly lower rate of postoperative transfusions was observed for obese patients (OR 0.581, 95% CI 0.432-0.781, p<0.001). Obesity was found to be independently associated with an increased risk of overall complication, developing acute renal failure, and having an unplanned 30-day readmission following tracheostomy. The risk of postoperative transfusion appears to be lower in obese patients. 4.