Respiratory-Related Hospital Admissions in Children and Young Adults With Down Syndrome

BACKGROUND: Children with Down syndrome (DS) have an increased risk for hospitalization and intensive care owing to respiratory illnesses; however, current research does not specify which co-occurring diagnoses increase this risk throughout childhood. We aim to decrease morbidity by focusing outpatient care on the most critical diagnoses. This study examines which co-occurring diagnoses increase the risk of hospitalization and need for intensive care owing to respiratory tract infections in a large cohort of children with DS. METHODS: This retrospective review of children with DS (n = 2327), receiving care from a large clinic for children with DS between 2011 and 2023, evaluated clinical data and hospitalizations. Admission diagnosis, intensive care unit (ICU) support, co-occurring diagnoses, and demographics were reviewed. RESULTS: Thirty percent (n = 703) of children with DS had a hospital admission owing to respiratory illness, with 340 (48.4%) having more than one inpatient stay and 65 (9.2%) requiring ICU care. Most common admission reasons were pneumonia, bronchiolitis, and respiratory failure/distress. Median age at first admission was 2.0 years (mean = 3.0 years; SD = 4.3). Children diagnosed with chronic lung disease had 2.15 times higher odds of having a respiratory-related hospitalization. Children with chronic lung disease, dysphagia with aspiration, deep laryngeal penetration without aspiration, obstructive sleep apnea, asthma/reactive airway disease, pulmonary hypertension, laryngomalacia, and Medicaid insurance status were more likely to require multiple hospital admissions. DISCUSSION: Children with DS have a high rate of hospital admissions related to respiratory tract infections. Co-occurring pulmonary diagnoses increase the risk of recurrent hospitalizations.