Respiratory morbidity of hospitalized children with Trisomy 21

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 resp iratory pathology, (iii) admission to the Intensive Care Unit (ICU), (iv) l ength of stay and (v) costs of admission. Results: Fifty-four per cent of admissions were primarily for respiratory t ract 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 (w ithout CHD) with common respiratory conditions such as bronchiolitis, asthm a or pneumonia was two to three times greater than in patients without Tris omy 21. Conclusions: Lower respiratory pathology is most common cause for acute hos pital admission in children with Trisomy 21. The presence of CHD did not in fluence 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 sup port.