The Impact of Obstructive Sleep Apnea on Bronchiolitis Severity in Children with Down Syndrome: A Kids' Inpatient Database Study
Year: 2021
Type: conference-abstract
Abstract: Rationale Acute bronchiolitis commonly causes respiratory failure in children 2 years, and is particularly severe in those with Down syndrome (DS). Obstructive sleep apnea (OSA), common in DS, is also associated with respiratory complications. However, it is unknown whether OSA contributes to worse outcomes in children, with and without DS, hospitalized with bronchiolitis. We hypothesized that, in children with acute bronchiolitis OSA would be associated with worse outcomes only in those with DS, independent of DS-related comorbidities. Methods Hospital discharge records of children with bronchiolitis aged 2 years were obtained for 1997-2012 from the Kid's Inpatient Database. The primary outcome was invasive mechanical ventilation (IMV), and secondary outcomes were non-invasive mechanical ventilation (NIMV), length of hospital stay, and inflation-adjusted cost of hospitalization. Multivariable regression was conducted to ascertain the associations between OSA and primary and secondary outcomes accounting for DS-associated comorbidities. Results There were 928,961 hospitalizations for acute bronchiolitis. The DS group with acute bronchiolitis (n=8,697) was more likely to have OSA [241 (2.77%) vs 1,293 (0.14%), p<0.001] compared to the non-DS group (n=920,264). Multivariable logistic regression showed that OSA was associated with IMV (adjusted odds ratio [OR], 3.32 [95% CI 2.54-4.35], p<0.0001) in all children with bronchiolitis; and in those with DS, it was associated with IMV (adjusted OR,], p=0.002), NIMV (adjusted OR,.04], p<0.0001) and inflation-adjusted costs of hospitalization. Conclusions OSA is an independent risk factor assisted ventilation in all children hospitalized with acute bronchiolitis, regardless of DS-associated comorbidities in those with DS. Data suggest that the severity of bronchiolitis in children with DS may be driven by the high prevalence of OSA in this population.
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4242550190