Percutaneous vs. Surgical Tracheostomy: A Comparative Analysis of Efficiency, Cost, and Hospital Stay

Introduction Tracheostomy is a regularly performed procedure for patients requiring prolonged ventilatory support in the intensive care unit (ICU). Our community hospital implemented a new percutaneous tracheostomy (PT) program in an attempt to decrease operational costs and navigate operating room limitations. After the successful rollout, we performed a study comparing PT and surgical tracheostomy (ST) in terms of efficiency, ICU stay, and cost after one year to determine the outcomes a community hospital could expect in the early stages of PT implementation.  Methods This is a cohort study with retrospective data collected from hospital records for both ST and PT over the years 2023-2024. Outcomes measured included consult-to-procedure time, procedural duration, ICU stay, and cost. Statistical significance was set at p<0.05.  Results PT had a significantly shorter consult-to-procedure time (p=0.0039), with a mean of 1.76 days, compared to 4.139 days for ST. PT was also faster in procedural duration (p=0.0001), averaging 8.66 minutes, versus 53.93 minutes for ST. ICU length of stay showed no statistical difference (p=0.3919), with PT patients staying three days versus 3.79 days for ST. Cost analysis revealed PT was significantly more cost-effective, averaging $971.93, compared to $2,397.98 for ST.  Conclusion PT is a more efficient and cost-effective alternative to ST, significantly reducing consult-to-procedure time and procedure duration. Although ICU length of stay did not reach statistical significance, PT demonstrates clear advantages in terms of resource utilization and cost savings.