Background : Down’s syndrome (DS) is the most common congenital chromosomal anomaly and occurs in about 1:700 live birth globally. Reports stated an increasing survival rate because of advance medical and surgical care. The highest mortality in DS takes place in the first three years of life with its comorbidities are congenital heart disease, gastrointestinal defect and hypothyroidism. Currently, survival rate in Indonesia is still unknown, therefore we examined three-years survival rate among children with DS in Sardjito General Hospital.
Material : We included all medical records with DS children, diagnosed based on clinical judgment or chromosomal analysis, in Sardjito General Hospital during 2013 to 2014. We excluded medical records with inadequate data. Survival rate was analysed using Kaplan-Meier curve for three years.
Results : The 1-year, 2-years and 3-years survival rate in Down’s syndrome children were 81.6%, 76.3 %, and 75.0 % respectively. Three years survival with heart defect was 66.7 % (50/75) and without was 83.1 % (64/78)(p=0.042). Furthermore, three years survival with gastrointestinal defect was 52.9 % (18/34) and without was 80.7 % (96/119) (p<0.005). The most common cause of death was sepsis and septic shock (48.6%, 19/38 patients) followed by pneumonia (13.2%, 5/38 patients), and acute respiratory distress syndrome (13.2%, 5/38 patients).
Conclusions : The survival rate in Sardjito General Hospital is still lower compared to other developed countries. This may be caused by the lack of antenatal diagnosis of Down’s syndrome and comprehensive management of patient. Further research is needed to analyse the cause.