Garrison Michelle M, Jeffries Howard, Christakis Dimitri A
Child Health Institute and Department of Pediatrics, University of Washington, Seattle, Washington 98195-4920, USA.
J Pediatr. 2005 Dec;147(6):748-52. doi: 10.1016/j.jpeds.2005.06.032.
To determine differences in case fatality rates between children with and without Down syndrome.
We used the Pediatric Health Information System (PHIS) database, which includes demographic and diagnostic data from freestanding children's hospitals. Using Poisson regression, we determined the risk of mortality from sepsis for children with Down syndrome, after controlling for potential confounding factors.
A total of 35,645 patients met our inclusion criteria, of which 3936 (11%) died during hospitalization. Altogether, 620 of the included patients also had a diagnosis of Down syndrome; 106 (17%) of these died during hospitalization. Children with Down syndrome had significantly elevated risk of mortality (mortality rate ratio = 1.30; 95% confidence interval = 1.06 to 1.59) after adjusting for potential confounding factors including demographics, pathogens, and concomitant conditions.
Children with Down syndrome and sepsis have elevated risk of mortality. These findings have implications for treatment decisions, communications about prognosis, and future research.
确定患有和未患有唐氏综合征的儿童之间的病死率差异。
我们使用了儿科健康信息系统（PHIS）数据库，该数据库包含独立儿童医院的人口统计学和诊断数据。通过泊松回归，在控制潜在混杂因素后，我们确定了唐氏综合征患儿败血症的死亡风险。
共有35645名患者符合我们的纳入标准，其中3936名（11%）在住院期间死亡。纳入的患者中共有620名也被诊断为唐氏综合征；其中106名（17%）在住院期间死亡。在调整包括人口统计学、病原体和伴随疾病等潜在混杂因素后，唐氏综合征患儿的死亡风险显著升高（死亡率比=1.30；95%置信区间=1.06至1.59）。
患有唐氏综合征和败血症的儿童死亡风险升高。这些发现对治疗决策、预后沟通和未来研究具有重要意义。
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