부산대학교 도서관

Keywords Obesity; Tracheostomy; Complications; Decannulation; Dislodgement Highlights * Obesity is associated with tracheostomy-associated complications. * Unplanned dislodgement or decannulation (DD) can be a life-threatening complication. * Skin-to-trachea distance (STT) strongly correlated with body mass index (BMI). * STT [greater than or equal to]80 mm was a better predictor of unplanned DD than BMI. * Measuring STT prior to tracheostomy may identify high risk patients for unplanned DD. Abstract Background Obesity is a risk factor for tracheostomy-related complications. We aimed to investigate whether obesity was associated with a risk of unplanned tracheostomy dislodgement or decannulation (DD). Methods Retrospective review of patients undergoing tracheostomy at a single institution from 2013 to 2019 was performed. The primary outcome was unplanned DD within 42 days. Obesity was assessed by body mass index (BMI) and skin-to-trachea distance (STT) measured on computed tomographic images. Results 25 (12%) episodes of unplanned DD occurred in 213 patients within 42 days. BMI [greater than or equal to]35 kg/m.sup.2 was associated with STT [greater than or equal to]80 mm (p < 0.0001). On multivariate analysis, STT [greater than or equal to]80 mm but not BMI was an independent predictor of unplanned DD (hazard ratio = 8.34 [95% confidence interval 2.85--24.4]). Conclusions STT [greater than or equal to]80 mm was a better predictor of unplanned DD than BMI. Assessment of STT in addition to BMI may be useful to identify patients that would benefit from extended length tracheostomy tubes. Author Affiliation: (a) Department of Surgery, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA (b) Drexel University College of Medicine, Philadelphia, PA, USA (c) Haverford College, Haverford, PA, USA (d) Department of Surgery, Reading Hospital, Tower Health System, Reading, PA, USA (e) Department of Statistics and Mathematics, University of Massachusetts at Amherst, Amherst, MA, USA * Corresponding author. Department of Surgery, Philadelphia College of Osteopathic Medicine, 4190 City Avenue, 4th Floor, Suite 409, Philadelphia, PA, 19131, USA. Article History: Received 25 June 2021; Revised 12 November 2021; Accepted 30 November 2021 (footnote)[white star] Senior Author: Adrian Ong, MD, Department of Surgery, Reading Hospital, 420 S. 5th Avenue, Reading PA 19611. Phone: 484-628-4884; fax: 484-628-4880 Email: adrian.ong@towerhealth.org Byline: Ryan Wan (a), Hannah Shin [hannahsh@pcom.edu] (a,*), Courtney Docherty (a), Hamza Bhatti (a), Chelsea Spector (b), Brian Thai (c), Alison Muller (d), Anthony Martin (d), Krista Gile (e), Anna Liu (e), Adrian Ong (d)