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唐氏综合征患儿住院的原因。

Causes of Hospitalization in Children with Down Syndrome.

机构信息

Department of Pediatrics, Botucatu Medical School, São Paulo State University (UNESP), Botucatu 18618-000, São Paulo, Brazil.

Department of Biostatistics, Institute of Biosciences, São Paulo University (UNESP), Botucatu 18618-000, São Paulo, Brazil.

出版信息

Medicina (Kaunas). 2024 Sep 10;60(9):1480. doi: 10.3390/medicina60091480.

Abstract

: Down syndrome (DS) is the most common chromosomal disorder in the world. It is caused by the imbalance of the chromosomal constitution of 21 by free trisomy, translocation or mosaicism. Children and adolescents with Down syndrome have immune dysregulation and are more susceptible to infections. This study aims to evaluate hospitalizations of children and adolescents with DS in the pediatric ward of Botucatu Clinics Hospital (HCFMB) and to classify the population of children included in the study according to age, diagnosis, outpatient follow-up, length of stay and need for the intensive care unit (ICU). Thus, it will be possible to improve care for these children, aiming to reduce these hospitalizations. : This study was an observational, cross-sectional study, with retrospective data collected from the last nine years of hospitalization, from January 2013 to December 2021, from children and adolescents with DS in the pediatric ward, emergency room, and the ICU of HCFMB. Children hospitalized in this period in the pediatric ward and ICU, in the age range of 30 days to 15 years, were included in this study. The evaluation of comorbidities that culminated in the need for hospitalization in this population can be the focus of actions to improve the diagnoses and conducts for this population, which can prevent worsening illness and hospitalizations in future populations. : In this analysis, 80 children with DS were evaluated, with a total of 283 hospitalizations. The most prevalent age group was 1 to 3 years, and the main cause was due to problems in the respiratory system (99 cases). Among the respiratory causes, the main cause of hospitalization was due to pneumonia in 50% of cases, followed by acute respiratory failure in 14%. The average hospitalization time was 8 days, and in 49 hospitalizations, the children required the ICU. The main cause of hospitalization in the ICU was due to respiratory causes (36%), followed by cardiac malformations (14%). During the ICU hospitalizations, there were 13 deaths, and we observed a higher prevalence of heart conditions and, in some cases, positive urine cultures in these children. The Hospital serves as a reference for pediatric hospitalizations within its region and beyond, owing to its specialized capabilities. The main causes of hospitalization were those related to the respiratory system and cardiac malformations. Roughly one-third of the children required admission to the intensive care unit.

摘要

唐氏综合征(DS)是世界上最常见的染色体疾病。它是由 21 号染色体组成的不平衡引起的,包括自由三体、易位或嵌合体。唐氏综合征患儿存在免疫失调,更容易感染。本研究旨在评估布图卡图临床医院(HCFMB)儿科病房中唐氏综合征患儿的住院情况,并根据年龄、诊断、门诊随访、住院时间和对重症监护病房(ICU)的需求对纳入研究的患儿进行分类。这样,就有可能改善对这些儿童的护理,旨在减少这些住院治疗。

本研究为观察性、横断面研究,回顾性收集了 2013 年 1 月至 2021 年 12 月过去 9 年期间 HCFMB 儿科病房、急诊室和 ICU 中唐氏综合征患儿的住院数据。本研究纳入了该时期儿科病房和 ICU 中年龄在 30 天至 15 岁之间的住院患儿。评估导致该人群住院的合并症可能是为该人群改善诊断和治疗的重点,这可以预防未来人群病情恶化和住院治疗。

在这项分析中,评估了 80 名唐氏综合征患儿,共 283 例住院。最常见的年龄组为 1 至 3 岁,主要病因是呼吸系统问题(99 例)。在呼吸系统病因中,因肺炎住院的主要原因占 50%,其次是急性呼吸衰竭占 14%。平均住院时间为 8 天,49 例患儿需要入住 ICU。入住 ICU 的主要原因是呼吸系统疾病(36%),其次是心脏畸形(14%)。在 ICU 住院期间,有 13 人死亡,我们观察到这些儿童心脏状况的发病率较高,在某些情况下尿液培养呈阳性。该医院因其专业能力,不仅为本地区,也为其他地区的儿科住院治疗提供服务。主要的住院原因是与呼吸系统和心脏畸形有关的疾病。大约三分之一的患儿需要入住重症监护病房。

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