Clinical outcomes and safety of percutaneous dilatational tracheostomy in patients with severe traumatic brain injury.

To evaluate the therapeutic outcomes of percutaneous dilatational tracheostomy (PDT) and surgical tracheostomy (ST) in patients with severe traumatic brain injury (sTBI). Clinical records of sTBI patients treated at West China Hospital, Sichuan University, between January 2022 and December 2024 were retrospectively analyzed in this study. A total of 116 patients underwent PDT and 104 underwent ST. Clinical data were compared between groups, including surgical details, perioperative parameters, physiological stability, postoperative inflammatory markers, clinical efficacy, complications, and quality of life. Compared with ST, PDT was associated with shorter operative time, smaller incision, faster wound healing, reduced intraoperative blood loss, shorter ventilation duration, and decreased lengths of ICU and hospital stay (P < 0.001). During cannulation, PDT caused smaller fluctuations in physiological parameters (P < 0.05). On postoperative day 7, levels of C-reactive protein (CRP), procalcitonin (PCT), erythrocyte sedimentation rate (ESR), white blood cells (WBCs), and neutrophils (NEU) were significantly lower in the PDT group (P < 0.001). Moreover, PDT showed fewer complications (7.76% vs. 17.31%, P < 0.05), higher clinical response rates (97.41% vs. 91.35%, P < 0.05), and improved quality of life scores (P < 0.001). In patients with sTBI, PDT offers advantages over ST, including easier operation, less trauma, mild postoperative inflammatory reaction, and faster recovery. It effectively lowers complication rates, enhances clinical efficacy, and improves quality of life, demonstrating high safety and broad applicability.