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This increased risk contributes to escalated levels of morbidity and mortality. In this study, we sought to analyze nationwide data of pediatric and adult patients with Down syndrome and congenital heart disease over a 15-year period. Data obtained from the hospital discharge form between 2001 and 2016 of patients diagnosed with Down syndrome in Italy and at least one congenital heart disease were included. Information on 12362 admissions of 6527 patients were included. Age at first admission was 6.2\u2009\u00b1\u200912.8 years and was a predictor of mortality (HR\u2009=\u20091.51, 95% CI 1.13\u20132.03, <jats:italic>p<\/jats:italic>\u2009=\u20090.006). 3923 (60.1%) patients underwent only one admission, while 2604 (39.9%) underwent multiple (&gt;\u20091) admissions. There were 5846 (47.3%) admissions for cardiac related symptoms. Multiple admissions (SHR: 3.13; 95% CI: 2.99, 3.27; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01) and cardiac admissions (SHR: 2.00; 95% CI: 1.92, 2.09; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01) were associated with an increased risk of additional potential readmissions. There was an increased risk of mortality for patients who had cardiac admissions (HR\u2009=\u20091.45, 95% CI: 1.08\u20131.94, <jats:italic>p<\/jats:italic>\u2009=\u20090.012), and for those who underwent at least 1 cardiac surgical procedure (HR\u2009=\u20091.51, 95% CI 1.13\u20132.03, <jats:italic>p<\/jats:italic>\u2009=\u20090.006).<\/jats:p><jats:p><jats:italic>Conclusions<\/jats:italic>: A younger age at first admission is a predictor for mortality in patients with Down syndrome and congenital heart disease. If patients undergo more than one admission, the risk of further readmissions increases. There is a pivotal role for heart disease in influencing the hospitalization rate and subsequent mortality.<\/jats:p><jats:p><jats:table-wrap><jats:table><jats:tbody>\n                    <jats:tr>\n                      <jats:td colspan=\"2\"><jats:bold>What is Known:<\/jats:bold>\u2022 <jats:italic>Down syndrome individuals often face an increased risk of congenital heart diseases.<\/jats:italic>\u2022 <jats:italic>Congenital heart diseases contribute significantly to morbidity and mortality in Down syndrome patients.<\/jats:italic><\/jats:td>\n                    <\/jats:tr>\n                    <jats:tr>\n                      <jats:td colspan=\"2\"><jats:bold>What is New:<\/jats:bold>\u2022 <jats:italic>This study analyzes nationwide data covering a 15-year period of pediatric and adult patients in Italy with Down syndrome and congenital heart disease.<\/jats:italic>\u2022 <jats:italic>It identifies a younger age at first admission as a predictor for mortality in these patients, emphasizing the criticality of early intervention.<\/jats:italic>\u2022 <jats:italic>Demonstrates a correlation between multiple admissions, particularly those related to cardiac issues, and an increased risk of further readmissions, providing insights into the ongoing healthcare needs of these individuals.<\/jats:italic><\/jats:td>\n                    <\/jats:tr>\n                  <\/jats:tbody><\/jats:table><\/jats:table-wrap><\/jats:p>","DOI":"10.1007\/s00431-024-05542-2","type":"journal-article","created":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T15:45:14Z","timestamp":1713282314000},"page":"2945-2954","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nationwide hospitalizations of patients with down syndrome and congenital heart disease over a 15-year period"],"prefix":"10.1007","volume":"183","author":[{"given":"Alvise","family":"Guariento","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Cattapan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Lorenzoni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Guerra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilias P.","family":"Doulamis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"di Salvo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dario","family":"Gregori","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vladimiro L.","family":"Vida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,4,16]]},"reference":[{"key":"5542_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41572-019-0143-7","volume":"6","author":"SE Antonarakis","year":"2020","unstructured":"Antonarakis SE, Skotko BG, Rafii MS et al (2020) Down syndrome. 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The authors have no relevant financial or non-financial interests to disclose. All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Alvise Guariento, Claudia Cattapan, Giulia Lorenzoni, Giulia Guerra, Ilias P. Doulamis, Giovanni di Salvo, Dario Gregori, Vladimiro Vida. The first draft of the manuscript was written by Alvise Guariento, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.\u00a0The Italian Ministry of Health granted authorized access to anonymized data in compliance with health information processing regulations. Our retrospective analysis of anonymized public data, devoid of direct interaction with individuals or service adjustments, rendered ethics committee approval unnecessary.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}