[Clinical characteristics of patients with fatal hemorrhage following percutaneous dilational tracheostomy].

Objective: To summarize the clinical characteristics of patients who experienced fatal hemorrhage following percutaneous dilatational tracheostomy (PDT). Methods: Among 2 560 patients who undergoing PDT in Tianjin Huanhu Hospital from January 2020 to January 2025, 4 patients(3 males and 1 female,age between 37 to 71 years old,with a median age of 50.5)developed fatal hemorrhage. Clinical data, including age, gender, type of disease, bleeding time, bleeding site, and final outcome were retrospectively reviewed. Additionally, potential causes of fatal hemorrhage following PDT were analyzed. Results: Three patients experienced fatal subclavian artery hemorrhage. Two of them (one with obesity and the other with an elongated neck) died of massive hemorrhage within one month postoperatively. The third patient with subclavian artery injury succumbed to bleeding six months after PDT. The fourth patient died from thyroid artery bleeding secondary to tracheostomy stoma infection. Conclusion: Fatal bleeding following PDT carries a grave prognosis and a extremely high mortality. Given its lethality, primary prevention through meticulous patient selection, anatomical assessment, and procedural technique remains paramount.