title: Association between Down syndrome and mortality in young children with critical illness: a propensity-matched analysis.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Pediatric Cardiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Punkaj
authors.initials: P
authors.lastname: Gupta
authors.affiliation: Biostatistics Program, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Mallikarjuna
authors.initials: M
authors.lastname: Rettiganti
mesh_terms: D002675:Child, Preschool; D015331:Cohort Studies; D016638:Critical Illness; D004314:Down Syndrome / Q000150:complications / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D057216:Propensity Score; D012307:Risk Factors
keywords: Children; Critical illness; Down syndrome; Mortality; Propensity matching