Department of Otolaryngology, University of California San Diego, La Jolla, California, U.S.A.
Department of Otolaryngology, The University of Alabama at Birmingham, Birmingham, Alabama, U.S.A.
Laryngoscope. 2024 Nov;134(11):4674-4681. doi: 10.1002/lary.31586. Epub 2024 Jun 19.
To examine the impact of increased body mass index (BMI) on (1) tracheotomy timing and (2) short-term surgical complications requiring a return to the operating room and 30-day mortality utilizing data from the Multi-Institutional Study on Tracheotomy (MIST).
A retrospective analysis of patients from the MIST database who underwent surgical or percutaneous tracheotomy between 2013 and 2016 at eight institutions was completed. Unadjusted and adjusted logistic regression analyses were used to assess the impact of obesity on tracheotomy timing and complications.
Among the 3369 patients who underwent tracheotomy, 41.0% were obese and 21.6% were morbidly obese. BMI was associated with higher rates of prolonged intubation prior to tracheotomy accounting for comorbidities, indication for tracheotomy, institution, and type of tracheostomy (p = 0.001). Morbidly obese patients (BMI ≥35 kg/m) experienced a longer duration of intubation compared with patients with a normal BMI (median days intubated [IQR 25%-75%]: 11.0 days [7-17 days] versus 9.0 days [5-14 days]; p < 0.001) but did not have statistically higher rates of return to the operating room within 30 days (p = 0.12) or mortality (p = 0.90) on multivariable analysis. This same finding of prolonged intubation was not seen in overweight, nonobese patients when compared with normal BMI patients (median days intubated [IQR 25%-75%]: 10.0 days [6-15 days] versus 10.0 days [6-15 days]; p = 0.36).
BMI was associated with increased duration of intubation prior to tracheotomy. Although morbidly obese patients had a longer duration of intubation, there were no differences in return to the operating room or mortality within 30 days.
3 Laryngoscope, 134:4674-4681, 2024.
利用多机构气管切开术研究（MIST）的数据，研究体重指数（BMI）升高对（1）气管切开时机和（2）需要返回手术室的短期手术并发症以及 30 天死亡率的影响。
对 2013 年至 2016 年在 8 家机构接受手术或经皮气管切开术的 MIST 数据库患者进行回顾性分析。使用未调整和调整后的逻辑回归分析评估肥胖对气管切开时机和并发症的影响。
在 3369 名接受气管切开术的患者中，41.0%为肥胖，21.6%为病态肥胖。BMI 与因合并症、气管切开术指征、机构和气管造口术类型而导致的气管切开术前长时间插管的发生率较高相关（p = 0.001）。病态肥胖患者（BMI≥35kg/m）与 BMI 正常的患者相比，插管时间更长（中位数插管天数[IQR 25%-75%]：11.0 天[7-17 天]比 9.0 天[5-14 天]；p<0.001），但在多变量分析中，30 天内返回手术室的比率（p = 0.12）或死亡率（p = 0.90）并无统计学差异。与 BMI 正常的患者相比，超重但非肥胖的患者并没有出现这种插管时间延长的情况（中位数插管天数[IQR 25%-75%]：10.0 天[6-15 天]比 10.0 天[6-15 天]；p = 0.36）。
BMI 与气管切开术前插管时间延长有关。虽然病态肥胖患者的插管时间较长，但在 30 天内返回手术室或死亡率方面没有差异。
3 级喉镜，134：4674-4681，2024。
