Emily DeBoer, Kristine Wolter-Warmerdam, Rebecca Bernstein, Arwen Jackson, Jennifer Maybee, Karen Kelminson, Francis Hickey
University of Colorado and Children’s Hospital Colorado.
United States
Hospital Pediatrics
Hosp Pediatr 2026;
DOI: 10.1542/hpeds.2025-008731
Abstract
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.
Category
Genetic Factors Associated with Pulmonary Vascular Disease
Quality of Life Associated with Pulmonary Vascular Disease
Symptoms and Findings Associated with Pulmonary Vascular Disease
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
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