Affiliation:
1. Department of Otolaryngology – Head and Neck Surgery McGill University Health Centre Montreal Canada
2. Department of Otolaryngology – Head and Neck Surgery University of Manitoba Winnipeg Canada
3. Faculty of Medicine and Health Sciences McGill University Montreal Canada
Abstract
ObjectiveThis study aimed to assess the safety and efficacy of endoscopic percutaneous dilatational tracheostomy (PDT) in obese and nonobese critically ill adults.MethodsA retrospective study of all cases of PDT performed at two academic health centers between 2016 and 2023 was conducted. Primary outcomes included peri‐ and postoperative complications stratified by both timing and severity. body mass index (BMI) data were stratified according to the World Health Organization classification (class I obesity defined as BMI ≥ 30, class II obesity ≥35 and <40, class 3 obesity ≥40).ResultsTotally 336 patients underwent a PDT, 279 of whom had available BMI data: 193 (69.2%) patients had a normal BMI, 56 (20.1%) had class I obesity, 15 (5.4%) class II obesity, and 15 (5.4%) class III obesity. The overall complication rates for the class I, II, and III obesity were 8.9%, 13.3%, and 13.3%, respectively. All procedures were successfully completed at the bedside (no conversions to an open approach), and there was no procedure‐related mortality. The only accidental decannulation event was in a patient with class III obesity. There was no difference in overall complication rates between patients without obesity and patients with obesity (7.3% vs. 10.5%, respectively, p = 0.370).ConclusionThis study significantly expands the current literature and represents one of the largest studies to date reporting on PDT in patients with obesity.Level of Evidence3 Laryngoscope, 2024