Etiology-Based Clinical Outcomes after Pediatric Tracheostomy in Intensive Care: A Retrospective Observational Study

Aim: To evaluate etiology-based differences in clinical outcomes among pediatric patients undergoing tracheostomy in a tertiary pediatric intensive care unit. Materials and Methods:In this retrospective observational study, the medical records of patients aged 1 month to 18 years who had undergone tracheostomy between October 2023 and December 2025 were reviewed.The patients were classified into three etiological groups: neuromuscular diseases, chronic respiratory failure, and upper airway obstruction/malformation.Their demographic characteristics, mechanical ventilation durations, intensive care and hospital length of stay, complications, and clinical outcomes were analyzed.Results: A total of 59 patients were included.The most common tracheostomy indications were neuromuscular diseases (52.5%) and chronic respiratory failure (33.9%).Significant differences were observed among the groups regarding their age, anthropometric measurements, and mechanical ventilation durations (p<0.05).Those patients with chronic respiratory failure had longer pre-and post-tracheostomy mechanical ventilation durations and the lowest successful ventilator weaning rate.Early and late complication rates were 10.2% and 25.4%, respectively.The decannulation rate was 5.1%, and overall mortality was 22%.Conclusion: Tracheostomy indication was significantly associated with clinical outcomes in pediatric intensive care patients.Those patients with chronic respiratory failure demonstrated prolonged mechanical ventilation and lower ventilator weaning success.Etiology-based individualized management strategies warrant further investigation in this population.