Pascal Gaechter, Fahim Ebrahimi, Alexander Kutz, Gabor Szinnai
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引用次数: 0
Abstract
Background: People with Down syndrome suffer from multiple associated diseases. However, knowledge on rates and causes of hospitalizations is limited.
Methods: This population-based cohort study used national hospital claims data in Switzerland between January 1, 2012 and December 31, 2020. Included were hospitalizations of people aged 0-90 years. People with Down syndrome were identified using ICD-10-GM code Q90 and were compared to the general population. The primary outcome was the hospitalization rate. Secondary outcomes were the primary reasons for hospitalizations, secondary diagnoses, and in-hospital outcomes. Analyses were stratified by three age groups: neonates and infants (0-12 months), children and adolescents (1-17 years), and adults (18-90 years). We calculated incidence rates, risk ratios (RR), and regression coefficients with corresponding 95% confidence intervals (CI).
Findings: Among 9,992,538 hospitalizations, 5697 were identified for people with Down syndrome. Hospitalization rate for people with Down syndrome was highest in the first two years of life. In the total general population, it was highest in adults beyond 60 years. Primary reasons for hospitalization among people with Down syndrome were classified as diagnoses of the circulatory system (neonates and infants: RR 13.3 [95% CI 12.0-14.6], children and adolescents: RR 3.3 [95% CI 2.7-3.9]), and infectious diseases (adults: RR 4.0 [95% CI 3.7-4.2]). At birth, individuals with Down syndrome typically had an average of six diagnoses, a number that the general population reaches, on average, by the age of 69. People with Down syndrome experienced worse in-hospital outcomes, including longer stays in both the hospital and intensive care unit by a factor of 1.7 and a higher all-cause in-hospital mortality by an overall rate difference of 1.9%.
Interpretation: The findings underscore the medical complexity of hospitalized people with Down syndrome and emphasize the need for a comprehensive, age-inclusive approach to improve in-hospital outcomes and anticipate emergency hospitalizations across age groups.
背景：唐氏综合症患者患有多种相关疾病。然而，关于住院率和原因的知识有限。方法：这项基于人群的队列研究使用了2012年1月1日至2020年12月31日瑞士国家医院索赔数据。其中包括0-90岁住院患者。唐氏综合症患者使用ICD-10-GM代码Q90进行识别，并与一般人群进行比较。主要观察指标是住院率。次要结局是住院、二次诊断和住院结局的主要原因。分析按三个年龄组进行分层：新生儿和婴儿（0-12个月）、儿童和青少年（1-17岁）和成人（18-90岁）。我们计算了发病率、风险比（RR）和相应95%置信区间（CI）的回归系数。研究结果：在99992538例住院患者中，5697例确诊为唐氏综合征患者。唐氏综合症患者的住院率在出生后的头两年最高。在总人口中，60岁以上的成年人发病率最高。唐氏综合征患者住院的主要原因被分类为循环系统诊断（新生儿和婴儿：RR 13.3 [95% CI 12.0-14.6]，儿童和青少年：RR 3.3 [95% CI 2.7-3.9]）和传染病（成人：RR 4.0 [95% CI 3.7-4.2]）。患有唐氏综合症的人在出生时平均会被诊断出六种，而一般人在69岁时平均会达到这个数字。唐氏综合症患者的住院结果更差，包括在医院和重症监护病房的住院时间延长了1.7倍，全因住院死亡率也更高，总体差异为1.9%。解释：研究结果强调了唐氏综合征住院患者的医疗复杂性，并强调需要一个全面的、年龄包容的方法来改善住院结果，并预测各年龄组的紧急住院情况。资助：Kantonsspital Aarau AG。
期刊介绍：
eClinicalMedicine is a gold open-access clinical journal designed to support frontline health professionals in addressing the complex and rapid health transitions affecting societies globally. The journal aims to assist practitioners in overcoming healthcare challenges across diverse communities, spanning diagnosis, treatment, prevention, and health promotion. Integrating disciplines from various specialties and life stages, it seeks to enhance health systems as fundamental institutions within societies. With a forward-thinking approach, eClinicalMedicine aims to redefine the future of healthcare.
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