Factors related to home health-care transition in trisomy 13

Am J Med Genet A. 2017 Oct;173(10):2635-2640. doi: 10.1002/ajmg.a.38371. Epub 2017 Aug 29.

Abstract

Trisomy 13 (T13) is accompanied by severe complications, and it can be challenging to achieve long-term survival without aggressive treatment. However, recently, some patients with T13 have been receiving home care. We conducted this study to investigate factors related to home health-care transition for patients with T13.We studied 28 patients with T13 born between January 2000 and December 2014. We retrospectively compared nine home care transition patients (the home care group) and 19 patients that died during hospitalization (the discharge at death group). The median gestational age of the patients was 36.6 weeks, with a median birth weight of 2,047 g. Currently, three patients (11%) have survived, and 25 (89%) have died. The home care group exhibited a significantly longer gestational age (38.9 vs. 36.3 weeks, p = 0.039) and significantly larger occipitofrontal circumference Z score (-0.04 vs. -0.09, p = 0.019). Congenital heart defects (CHD) was more frequent in the discharge at death group, with six patients in the home care group and 18 patients in the discharge at death group (67% vs. 95%, p = 0.047), respectively. Survival time was significantly longer in the home care group than in the discharge at death group (171 vs. 19 days, p = 0.012). This study has shown that gestational age, occipitofrontal circumference Z score at birth, and the presence of CHD are helpful prognostic factors for determining treatment strategy in patients with T13.

Keywords: congenital heart defects; gestational age; home care; occipitofrontal circumference; trisomy 13.

MeSH terms

  • Adult
  • Birth Weight
  • Chromosomes, Human, Pair 13 / genetics*
  • Female
  • Gestational Age
  • Home Care Services / statistics & numerical data*
  • Hospitalization / statistics & numerical data*
  • Humans
  • Infant, Newborn
  • Male
  • Prognosis
  • Retrospective Studies
  • Survival Rate
  • Trisomy 13 Syndrome / genetics*
  • Trisomy 13 Syndrome / mortality*