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先天性肾上腺皮质增生症患儿的住院模式:住院率和肾上腺危象随年龄下降。

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

作者信息

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

机构信息

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.

出版信息

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

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3801/4736605/6375edcfd9f6/IJE2016-5748264.001.jpg

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