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This study aims to determine the incidence of tracheocutaneous fistula (TCF) and identify characteristics associated with persistence. In this study, all successfully decannulated children (<18 years) between 2014 and 2020 at a tertiary children's hospital were included. The study results showed a total of 77 children met the inclusion criteria with a persistent TCF incidence of 65% (50/77). Children with a persistent TCF were younger at placement (1.4 years (SD: 3.3) vs. 8.5 years (SD: 6.5), and tracheostomy-dependent longer (2.8 years (SD: 1.3) vs. 0.9 years. On univariate analysis, placement under 12 months of age, duration of tracheostomy more than 2 years, short gestation, congenital malformations, newborn complications, maternal complications and chronic respiratory failure were associated with persistent TCF. Based on the results, it can be concluded that two-thirds of children will develop a persistent TCF after tracheostomy decannulation. Persistent TCF is correlated with a longer duration of tracheostomy and congenital malformations. Anticipation of this event in higher-risk children is necessary when caring for pediatric tracheostomy patients.
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