Hospital Admission Patterns in Children with CAH: Admission Rates and Adrenal Crises Decline with Age

R Louise Rushworth; Henrik Falhammar; Craig F Munns; Ann M Maguire; David J Torpy

doi:10.1155/2016/5748264

Hospital Admission Patterns in Children with CAH: Admission Rates and Adrenal Crises Decline with Age

Int J Endocrinol. 2016:2016:5748264. doi: 10.1155/2016/5748264. Epub 2016 Jan 6.

Authors

R Louise Rushworth¹, Henrik Falhammar², Craig F Munns³, Ann M Maguire⁴, David J Torpy⁵

Affiliations

¹ School of Medicine, Sydney, The University of Notre Dame, Australia, 160 Oxford Street, Darlinghurst, NSW 2010, Australia.
² Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, 171 76 Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 76 Stockholm, Sweden; Menzies School of Health Research and Royal Darwin Hospital, 105 Rocklands Drive, Tiwi, NT 0810, Australia.
³ Endocrinology and Diabetes, The Children's Hospital Westmead, Hawkesbury Road, Westmead, NSW 2145, Australia; Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia.
⁴ Endocrinology and Diabetes, The Children's Hospital Westmead, Hawkesbury Road, Westmead, NSW 2145, Australia.
⁵ Endocrine and Metabolic Unit, Royal Adelaide Hospital and University of Adelaide, North Terrace, Adelaide, SA 5000, Australia.

Abstract

Objective. To examine patterns of hospitalisation for acute medical conditions in children with congenital adrenal hyperplasia (CAH). Design. A retrospective study of hospitalisation using administrative data. Setting. All hospitals in NSW, Australia. Patients. All patients admitted with CAH and a random sample of admissions in patients aged 0 to 18 years without adrenal insufficiency (AI). Main Outcome Measures. Admissions and comorbidities by age and sex. Results. Of 573 admissions for medical problems in CAH children, 286 (49.9%) were in males, and 236 (41.2%) had a principal diagnosis of CAH or had an adrenal crisis (AC). 37 (6.5%) ACs were recorded. An infection was found in 43.5% (n = 249) of the CAH patient admissions and 51.7% (n = 1613) of the non-AI group, p < 0.001. Children aged up to one year had the highest number of admissions (n = 149) and six ACs (four in males). There were 21 ACs recorded for children aged 1-5 years. Older CAH children had fewer admissions and fewer ACs. No in-hospital deaths were recorded. Conclusions. Admission for medical problems in CAH children declines with age. An AC was recorded in 6.5% of the admissions, with the majority of ACs occurring in the 1 to 5 years age group and there were no deaths.