Acute Healthcare Utilization During the First Year After Hospital Discharge in Children With Trisomy 18

Survival of infants with trisomy 18 (T18) has improved with advances in neonatal intensive care and surgical management, yet postdischarge outcomes remain poorly characterized. This single-center retrospective cohort study included infants with T18 admitted to a Level III neonatal intensive care unit between 2008 and 2022. Survival and survival-to-discharge rates were analyzed by birth era. For patients discharged alive in the most recent era (2018-2022), emergency department (ED) visits and hospital admissions during the first year after discharge were evaluated. Among 87 infants with confirmed outcomes, overall survival and survival-to-discharge rates improved over time. Sixteen patients discharged alive in the late cohort were included in the postdischarge analysis. During the first year after discharge, 13 patients (81%) visited the ED at least once, and 11 (69%) required hospital admission. Respiratory disorders were the most frequent reason for admission, followed by urinary tract infections and gastrointestinal disorders. An exploratory analysis found no significant association between tracheostomy status and ED visits or hospital admissions. Two patients died within 1 year after discharge. Despite improving survival, infants with T18 experience substantial healthcare utilization after discharge, underscoring the need for structured multidisciplinary follow-up and robust home-based care support systems.