Rushworth R Louise, Falhammar Henrik, Munns Craig F, Maguire Ann M, Torpy David J
School of Medicine, Sydney, The University of Notre Dame, Australia, 160 Oxford Street, Darlinghurst, NSW 2010, Australia.
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.
Int J Endocrinol. 2016;2016:5748264. doi: 10.1155/2016/5748264. Epub 2016 Jan 6.
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.
目的。研究先天性肾上腺皮质增生症(CAH)患儿急性内科疾病的住院模式。设计。利用行政数据对住院情况进行回顾性研究。地点。澳大利亚新南威尔士州的所有医院。患者。所有因CAH入院的患者以及0至18岁无肾上腺功能不全(AI)患者入院情况的随机样本。主要观察指标。按年龄和性别划分的入院情况及合并症。结果。在CAH患儿573例内科问题入院病例中,286例(49.9%)为男性,236例(41.2%)主要诊断为CAH或发生肾上腺危象(AC)。记录到37例(6.5%)AC。在CAH患者入院病例中有43.5%(n = 249)发现感染,在非AI组中有51.7%(n = 1613)发现感染,p < 0.001。1岁及以下儿童入院次数最多(n = 149),有6例AC(4例为男性)。1至5岁儿童记录到21例AC。年龄较大的CAH患儿入院次数较少,AC也较少。未记录到院内死亡病例。结论。CAH患儿因内科问题入院的情况随年龄增长而减少。6.5%的入院病例记录到AC,大多数AC发生在1至5岁年龄组,且无死亡病例。