Peri-operative complications during percutaneous tracheostomy in obese patients.
The safety of percutaneous tracheostomy in 73 obese patients (body mass index > or = 27.5 kg.m(-2)) in a cohort of 474 adults was studied. Four percutaneous techniques were employed (percutaneous dilational tracheostomy, n = 48; Ciaglia Blue Rhino, n = 157; guide wire dilating forceps, n = 62, translaryngeal tracheostomy, n = 207). The overall complication rate was 43.8% (n = 32) in the obese group compared to 18.2% (n = 73) in the control group (p < 0.001). Seven (9.6%) obese patients suffered life-threatening complications compared to three non-obese patients (0.7%, p < 0.001). Obese patients had a 2.7-fold increased risk for peri-operative complications, and a 4.9-fold increased risk for serious complications. The data suggest that percutaneous tracheostomy in obese patients is associated with a considerably increased risk for peri-operative complications, especially for serious adverse events.
Byhahn
C
C
Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, J.W. Goethe-University Medical School, Theodor-Stern-Kai 7, D 60590 Frankfurt, Germany. c.byhahn@em.uni-frankfurt.de
Lischke
V
V
Meininger
D
D
Halbig
S
S
Westphal
K
K
D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications*; D012121:Respiration, Artificial; D012720:Severity of Illness Index; D014132:Trachea / Q000293:injuries; D014139:Tracheostomy / Q000009:adverse effects* / Q000379:methods