Pediatric Tracheotomy: Indications, Timing, and Clinical Outcomes

INTRODUCTION: This study aimed to evaluate the indications, timing, and clinical outcomes of pediatric tracheotomy cases managed at a single tertiary center over a 13-year period.
METHODS: A retrospective review was conducted of 110 pediatric patients (1 day–18 years) who underwent tracheotomy between 2010 and 2023. Demographic data, indications, tracheotomy timing (TIT), duration of hospitalization, complications, and mortality were analyzed. Statistical analyses included Mann-Whitney U, Kruskal-Wallis, and chi-square tests, with p<0,05 considered significant.
RESULTS: Among 110 pediatric patients, 66 were male, and 44 were female. The most common indication for tracheotomy was prolonged mechanical ventilation (80.9%), followed by airway obstruction (19.1%), which was more frequent in newborns (p=0,004). Hospital stay duration and tracheotomy timing were significantly shorter in airway obstruction cases than in prolonged ventilation (p<0,001), with significant differences among age groups (p=0,008 and p<0,001). Overall mortality was 31.8%, predominantly among patients with congenital or neurological comorbidities; no statistically significant association was found between mortality and tracheotomy indication (p=0,445).
DISCUSSION AND CONCLUSION: Pediatric tracheotomy remains a safe and effective intervention when performed with appropriate timing and multidisciplinary care. Our study reveals that early tracheotomy does not impact mortality rates; however, it does shorten hospital stay duration and reduce complications.

Keywords: Tracheotomy, Tracheotomy Timing, Pediatric, Indications, Outcomes