Postoperative Complications of Percutaneous Tracheostomy in a Tertiary Anesthesia Intensive Care Unit: A 10-Year Retrospective Observational Study

Intensive care units (ICUs) frequently perform percutaneous tracheostomy (PDT) on patients who need continuous mechanical ventilation. Percutaneous dilatational tracheostomy has a number of postoperative complications that vary in intensity and time, although being less invasive than surgical tracheostomy. This retrospective observational study looked at complication rates in adult patients who had PDT in a tertiary anesthetic ICU between January 2015 and December 2024. Patients who spent <30 days in the hospital overall were not included. The mean age of the 647 patients who were included was 67.1 ± 17.1 years. A total of 139 patients (21.5%) experienced complications following surgery. Minor bleeding and subcutaneous emphysema were among the minor complications (12.2%). Pneumothorax, bleeding requiring transfusion, and deep tissue infection were among the major complications (10.5%). Life-threatening complications (2.3%) included tracheoesophageal and tracheoarterial fistulas. There were no documented deaths from the surgery. Early postoperative surveillance is crucial, as the majority of problems (89.9%) happened within 7 days of surgery. Patients who developed complications had prolonged ICU stays and more complex treatment requirements during hospitalization. The results highlight the necessity of systematic postoperative care and surveillance by confirming that, despite PDT’s general safety, considerable morbidity can occur. These findings back up upcoming multicenter research aimed at improving patient outcomes and complication management procedures. Copyright © 2025 by Mutaz B. Habal, MD