The impact of obesity on adult tracheostomy complication rate.

OBJECTIVES/HYPOTHESIS Prospectively compare tracheostomy-related complications in obese patients with complications in nonobese patients. STUDY DESIGN Prospective cohort study. METHODS Adult patients undergoing tracheostomy were studied. Patients who had a prior tracheostomy were excluded. Complications were classified as intraoperative, early (within the first 2 weeks), or late. RESULTS A total of 151 patients met inclusion/exclusion criteria. Fifty-five percent of obese patients experienced at least one tracheostomy-related complication; 19.5% of the control group had a complication. Mean procedure duration for patients with body mass index < 30 was 24.74 minutes and for obese patients was 46.17 minutes. There was a statistically significant effect of body mass index on complication rate (P < .0001) and on procedure duration (P < .0001). The relationships between body mass index and intraoperative complications (P = .027) and early postoperative complications (P = .001) were significant. CONCLUSIONS The tracheostomy-related complication rate is significantly higher for obese patients, especially for body mass index ≥ 35, especially in the intraoperative and early postoperative time periods. Procedure duration is significantly longer in obese patients.