Reasons, Outcomes, and Risk Factors for Emergency Department Visits in Pediatric Tracheostomy Patients: A Five-Year Single-Center Study

Aim: To evaluate the frequency, causes, and clinical outcomes of emergency department (ED) visits among pediatric patients with tracheostomies and to identify the risk factors associated with frequent ED utilization. Materials and Methods:This retrospective case-control study included pediatric patients (0-18 years) with tracheostomies who were followed up at a tertiary care center between January 2020 and December 2024.Patients were divided into two groups based on the number of ED visits per year (<2 vs. 2).Demographic, clinical, and caregiver-related data were collected.Statistical analyses were conducted to identify factors associated with frequent ED visits.Results: A total of 157 patients were included, with a median age of 28 months at the time of tracheostomy.During the 5-year period, these patients visited the ED 978 times.The most common reasons for ED visits were tracheostomy cannula replacement (37.9%) and acute respiratory failure (20.1%).Patients who visited the ED 2 times per year (n=31, 19.7%) were more likely to be fed orally (p=0.006),have less caregiver training in tracheostomy and device care (p=0.014 and p=0.030, respectively), and have Pseudomonas aeruginosa colonization (p=0.020).Mortality was also significantly higher in this group (32.3% vs. 11.9%,p=0.011). Conclusion:Frequent ED visits in children with tracheostomies are associated with modifiable factors such as feeding method, caregiver training, and chronic airway colonization.Structured education programs and preventive care strategies may reduce healthcare utilization and improve patient outcomes in this vulnerable population.