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Association between Down syndrome and mortality in young children with critical illness: a propensity‐matched analysis
Author(s) -
Gupta Punkaj,
Rettiganti Mallikarjuna
Publication year - 2015
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.13138
Subject(s) - medicine , propensity score matching , odds ratio , confidence interval , down syndrome , pediatrics , severity of illness , relative risk , intensive care unit , psychiatry
Aim To evaluate the outcomes among critically ill young children with Down syndrome using propensity score matching from a national database. Methods Patients in the age group from one day through 24 months admitted to an intensive care unit during their hospital stay at a Pediatric Health Information System ( PHIS )‐participating hospital (2004–2013) were included. Results Of the 293 697 patients who qualified for inclusion, 12 282 (4%) were classified in the Down syndrome group. Using propensity score matching, 10 477 patients with Down syndrome were matched one to one to patients without Down syndrome. Prior to matching, the mortality was significantly lower among the patients with Down syndrome (with vs. without Down syndrome, odds ratio ( OR ), 0.74; 95% confidence interval ( CI ), 0.69–0.79; p < 0.001). After matching, the mortality was similar in both groups ( OR , 0.96; 95% CI , 0.87–1.07; p = 0.51). The mortality risk increased among the Down syndrome patients with increasing hospital length of stay (LOS). Conclusion In this large, contemporary cohort, Down syndrome did not confer a significantly higher mortality risk among children with critical illness. However, children with Down syndrome followed a time‐dependent, differential mortality risk with increased risk noted in relation to increasing hospital LOS.