The rate of complications with percutaneous dilatational tracheostomy (PDT) is low among critically ill patients with obesity, although the risk may still be higher than in individuals without obesity, according to findings published in JAMA Otolaryngology—Head and Neck Surgery. Catherine Roy, MD, and colleagues conducted a systematic review of 18 studies with 1,355 patients with obesity who underwent PDT. Overall, the PDT-associated complication rate was 16.6% among patients
with obesity (N=791), the majority of which were not life-threatening. A small number of cases (8/1,314; 0.6%) were terminated or switched over to an open surgical tracheostomy (OST). A meta-analysis of 12 studies (1,078 patients with obesity; 3,134 patients without obesity) showed that patients with obesity had a higher rate of complications associated with PDT compared with those without obesity (risk ratio, 1.78; 95% CI, 1.38-2.28).
