Hospital admissions in children with down syndrome: experience of a population-based cohort followed from birth

PLoS One. 2013 Aug 13;8(8):e70401. doi: 10.1371/journal.pone.0070401. eCollection 2013.

Abstract

Objective: Children with Down syndrome, the most common genetic cause of intellectual disability, are prone to multiple and varied health-related problems. This study describes patterns of hospitalisations for children and young people with Down syndrome in Western Australia.

Methods: Birth records were linked to the Western Australian population-based Intellectual Disability database to identify all children born with Down syndrome in Western Australia between 1 January, 1983 and 31 December, 1999. These records were linked to the Hospital Morbidity Data System to provide information on all hospitalisations up to 31 December, 2004. Hospitalisation data, coded using ICD-9CM or ICD-10 (v0.5) were grouped into clinically relevant categories using the primary diagnosis. Rates of hospital admission for all and specific diagnoses were expressed in 1000-person-years at-risk and median age at first admission and length of stay were calculated.

Results: Of the 405 children, 395 had one or more hospital admissions, totalling 3786 admissions for all children and an estimated 39.5 person-years in hospital. On average, children were admitted 9.7 times, with an estimated rate of 757.2 admissions per 1000pyr (95% CI: 680, 843). A quarter of all admissions occurred in the first year of life. The average hospital length of stay was 3.8 days (95% CI: 3.7, 4.1). Upper respiratory tract conditions affected the most children (58.5%) and accounted for 12.1% of all admissions. Other disorders which affected a high percentage of children were ear/hearing conditions (50.6%), disorders of the oral cavity (38.0%) and lower respiratory tract conditions (37.5%). Overall, children with Down syndrome were hospitalised at a rate five times (95% CI = 4.3-6.2) that of the general population.

Conclusion: Children with Down syndrome are at increased risk of morbidity for varied causes underlining the importance of comprehensive and targeted primary care for this group.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Comorbidity
  • Down Syndrome / epidemiology*
  • Female
  • Follow-Up Studies
  • Hospital Mortality
  • Humans
  • Infant
  • Length of Stay
  • Male
  • Patient Admission*
  • Public Health Surveillance
  • Western Australia / epidemiology
  • Young Adult

Grant support

Funding was provided by the Australian National Health and Medical Research Council (NHMRC, http://www.nhmrc.gov.au/) Program Grants 572742, NHMRC Research Fellowship (572568) (to HL). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.