How Does Obesity Affect Postoperative Tracheotomy Outcomes?

Endotrachel tube, mechanical ventilation
To what extent does obesity affect postoperative tracheotomy outcomes, such as length of hospital stay, duration of ventilation, and ventilator use at discharge?

Among adults who undergo tracheotomy, those patients categorized as obese and morbidly obese have increased lengths of hospital stay, spend more time on a ventilator, and are more likely to be ventilator dependent at discharge than patients with lower body mass index (BMI). These were among study findings presented at the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) 2022 Annual Meeting and OTO Experience, held in Philadelphia, Pennsylvania, September 10 to 14, 2022.

Obesity is linked to increased risk for respiratory diseases that may require tracheotomy.

The researchers initiated a retrospective study of 391 adult patients who experienced tracheotomy between February 2017 and March 2020. Based on BMI data from electronic medical records, patients were divided into the following subgroups for analysis: underweight, normal weight, overweight, obese, and morbidly obese.

The researchers found significant differences between BMI subgroups with respect to length of stay and mechanical ventilation duration (P <.0001). Patients with BMI greater than 25.0 experienced longer hospital stays and longer ventilation durations compared with patients with normal weight. Higher BMI was associated with a higher proportion of patients being ventilator-dependent at discharge (P <.001). Researchers also noted a shorter time to cuff deflation for patients who were underweight or normal weight compared with the other 3 groups.

Researchers found no significant BMI-related differences among study participants with respect to time to decannulation (P =.241), time to trach collar placement (P =.367), time to tracheotomy capping (P =.072), time to first tracheotomy change (P =.165), or for type of tracheotomy procedure (P =.988).

Study limitations include the retrospective design.

Researchers concluded that “Obese and morbidly obese patients have increased length of hospital stays,” and that the obese and morbidly obese patients “are dependent on ventilators for longer and are more likely to be ventilator dependent at the time of discharge.”


Tucker J, Ruszkay NJ, Sandifer A, Goyal N, Goldenberg D, Gniady JP. Obesity is a risk factor for prolonged mechanical ventilation after tracheotomy. Otolaryngol Head Neck Surg. 2022;167(1 suppl):P19.

This article originally appeared on Pulmonology Advisor