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Respiratory morbidity of hospitalized children with Trisomy 21
J M Hilton1, D A Fitzgerald, D M Cooper
1Respiratory Department, John Hunter Children's Hospital, Newcastle, New South Wales, Australia.
Insights
Children with Trisomy 21 frequently require hospitalization for respiratory conditions like pneumonia. These children, especially those with congenital heart disease, experience longer hospital stays and increased need for intensive care.
Area of Science:
- Pediatric Pulmonology
- Clinical Genetics
- Hospital Medicine
Background:
- Children with Trisomy 21 (Down syndrome) are known to have increased susceptibility to respiratory infections.
- Understanding the patterns of respiratory morbidity is crucial for optimizing care and resource allocation.
Purpose of the Study:
- To investigate the respiratory morbidity in pediatric patients with Trisomy 21 admitted to a tertiary care center.
- To identify common respiratory pathologies and factors influencing admission outcomes.
Main Methods:
- A retrospective chart review was conducted for 232 admissions of children with Trisomy 21 over a 6.5-year period.
- Data collected included primary reason for admission, respiratory conditions, Intensive Care Unit (ICU) admission, length of stay, and costs.
Main Results:
- Respiratory tract pathology accounted for 54% of admissions, with pneumonia, bronchiolitis, and croup being most common.
- 10% of admissions required ICU care, primarily for pneumonia.
- Patients with Trisomy 21 and common respiratory conditions had 2-3 times longer hospital stays compared to those without Trisomy 21.
Conclusions:
- Lower respiratory pathology is the leading cause of acute hospital admission in children with Trisomy 21.
- Congenital heart disease (CHD) did not affect admission rates but was associated with longer stays, increased ICU admissions, and greater need for ventilatory support.
Objective:
To review the respiratory morbidity in children with Trisomy 21 admitted to a teaching hospital.
Methodology:
A retrospective chart review of 232 admissions to John Hunter Children's Hospital during a 6.5-year period (1991-98). The primary outcome measures included: (i) primary reason for admission, (ii) concomitant respiratory pathology, (iii) admission to the Intensive Care Unit (ICU), (iv) length of stay and (v) costs of admission.
Results:
Fifty-four per cent of admissions were primarily for respiratory tract pathology, dominated by pneumonia, bronchiolitis and croup. Admission to the ICU was required for 10% of admissions, most commonly for pneumonia (10/23). Congenital heart disease (CHD) was present in 33% of patients. The median length of stay and cost of admission for a child with Trisomy 21 (without CHD) with common respiratory conditions such as bronchiolitis, asthma or pneumonia was two to three times greater than in patients without Trisomy 21.
Conclusion:
Lower respiratory pathology is most common cause for acute hospital admission in children with Trisomy 21. The presence of CHD did not influence admission rates to hospital. However, patients with CHD had longer lengths of stay, appeared to have more severe illness, were more likely to require admission to an ICU and were more likely to require ventilatory support.
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