Hospitalization and survival following early vs. late percutaneous tracheostomy under bronchoscopic guidance - Retrospective analysis of 207 cases

Q: How was early versus late bronchoscopic-guided PDT defined in the study?

Early BG-PDT was performed within 7 days of intubation, while late PDT was performed from day 8 onward. All procedures occurred between 2012 and 2022.

Q: What outcomes differed between the early and late BG-PDT groups?

The early group had a shorter median overall hospitalization duration after BG-PDT. It also showed higher 1-year and 3-year survival rates compared with the late group.

Q: What factor was associated with better survival in the analysis?

Younger age correlated better with survival, with higher 1-year and 3-year survival rates observed in the early BG-PDT group versus the late group.

Sep 29, 2026

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Tracheostomy is performed for patients requiring prolonged mechanical ventilation, and it can be done bedside via percutaneous dilatational tracheostomy (PDT) with bronchoscopic guidance (BG). This retrospective study compared early versus late BG-PDT regarding complications and long-term survival using electronic medical records from 2012–2022. Early BG-PDT (within 7 days of intubation) showed shorter hospitalization and improved 1- and 3-year survival, with younger age linked to better outcomes.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusions

Keywords

Main study background and rationale

PDT and bronchoscopic guidance

Timing of tracheostomy and prior evidence

Gershman et al. BMC Pulmonary Medicine (2026) 26:3 [https://doi.org/10.1186/s12890-025-04043-8](https://doi.org/10.1186/s12890-025-04043-8) BMC Pulmonary Medicine RESEARCH Open Access Hospitalization and survival following early vs. late percutaneous tracheostomy under bronchoscopic guidance: a retrospective analysis of 207 cases Evgeni Gershman 1*, Doron Hausner2, Ido Neuman3, Lev Freidkin 1,3, Dror Rosengarten 1 and Mordechai R. Kramer 1 Abstract Background Tracheostomy is a commonly performed procedure for patients requiring prolonged mechanical ventilation. It can be performed at the bedside using percutaneous dilatational tracheostomy (PDT) under bronchoscopic guidance (BG), which reduces the need for surgical tracheostomies. The aim of this study was to compare early versus late BG-PDT in terms of complications and survival. Methods This retrospective study included patients who underwent BG-PDT between 2012 and 2022 at the Pulmonary Institute of Rabin Medical Center. Data was collected by reviewing demographic and clinical parameters from electronic medical records, with a minimum follow-up of 24 months after the BG-PDT procedure. Early BG-PDTwas defined as a procedure performed within 7 days of intubation and late PDT was performed from day 8 onward. Results A total of 207 BG-PDT procedures were performed between 2012 and 2022, of which 188 patients were included in the final analysis. The mean age of the patients was 69 years, with 57 . 5% being male. Patients who underwent early BG-PDT were younger (mean age 63 vs. 71, p < 0. 01) .The most common indications for PDT were respiratory disorders (47 . 8%) and neurological disorders (19 . 1%) . Patients in the early PDT group had a median overall hospitalization duration of 14 days post BG-PDT (IQR 21–31), compared to 33.5 days (IQR 26–47) in the late group (p < 0. 01) . The overall 1-year survival rate was 54 . 3% in the early BG-PDT group versus 30 . 1% in the late BG-PDT group (p = 0 . 04) . The overall 3-year survival for both groups was 24 . 2%, with 45 .4% in the early BG-PDT group and 19. 6% in the late BG-PDT group (p = 0 . 008) . Younger age was found to correlate better survival (OR 1. 05, 95% CI: 1.02–1. 08, p < 0. 001) and a higher one-year (54 . 3% vs. 30%, p = 0 . 04) and 3-year survival rate of 45 .4% in the early vs. 19. 6% in the late (p = 0 . 008) . Conclusions Bronchoscopy guided percutaneous dilatational tracheostomy is associated with shorter hospitalization duration and has possible survival advantages when performed within 7 days of intubation. Keywords Percutaneous tracheostomy, Bronchoscopy, Hospitalization, Survival *Correspondence: Evgeni Gershman [drgershmane@gmail.com](drgershmane@gmail.com) 1Pulmonary Institute, Rabin Medical Center, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel 2Anesthesiology Department, Rabin Medical Center, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel 3Department of Anesthesiology & Perioperative Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted u

FAQs

How was early versus late bronchoscopic-guided PDT defined in the study?

Early BG-PDT was performed within 7 days of intubation, while late PDT was performed from day 8 onward. All procedures occurred between 2012 and 2022.

What outcomes differed between the early and late BG-PDT groups?

The early group had a shorter median overall hospitalization duration after BG-PDT. It also showed higher 1-year and 3-year survival rates compared with the late group.

What factor was associated with better survival in the analysis?

Younger age correlated better with survival, with higher 1-year and 3-year survival rates observed in the early BG-PDT group versus the late group.

Sep 29, 2026

Uploaded by Blitz