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全国囊性纤维化住院趋势凸显了建立儿科到成人过渡诊所的必要性。

National Trends of Hospitalizations in Cystic Fibrosis Highlight a Need for Pediatric to Adult Transition Clinics.

机构信息

From the Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center.

Division of Pediatric Gastroenterology, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati, Cincinnati.

出版信息

Pancreas. 2021;50(5):704-709. doi: 10.1097/MPA.0000000000001815.

Abstract

OBJECTIVES

We hypothesized that hospitalizations in cystic fibrosis (CF) would reflect the development of age-related comorbidities.

METHODS

A retrospective analysis was performed using the Nationwide Inpatient Sample (2002-2017). Hospitalizations for which the principal diagnosis was CF were analyzed regarding age at discharge and presence of comorbidities. Trends were assessed for significance using the Cochran-Armitage test.

RESULTS

The mean age of patients hospitalized for CF increased from 19.7 years in 2002 to 23.0 years in 2017 (P = 0.017). Several comorbidities are more than 10 times more prevalent among adults as compared with children, including congestive heart failure, substance abuse, and chronic kidney disease (P < 0.001). In addition, diabetes with chronic complications was more prevalent in adults than children (10.0% vs 3.9%; P < 0.001), as was hypertension (7.2% vs 1.3%; P < 0.001) and osteoporosis (10.2% vs 1.9%; P < 0.001). More than 65% of CF hospitalizations in 2017 were in individuals older than 18 years.

CONCLUSIONS

Hospitalizations for adults with CF are increasing, and individuals with CF are developing age-related comorbidities. Providers equipped to manage the health care needs of adults need to be ready and able to care for this unique and growing patient population.

摘要

目的

我们假设囊性纤维化 (CF) 住院患者反映了与年龄相关的合并症的发展。

方法

本研究使用国家住院患者样本(2002-2017 年)进行回顾性分析。分析了以 CF 为主要诊断的住院患者的出院年龄和合并症情况。使用 Cochran-Armitage 检验评估趋势的显著性。

结果

因 CF 住院的患者的平均年龄从 2002 年的 19.7 岁增加到 2017 年的 23.0 岁(P = 0.017)。与儿童相比,成人中多种合并症的患病率超过 10 倍,包括充血性心力衰竭、药物滥用和慢性肾脏病(P < 0.001)。此外,成人中糖尿病伴慢性并发症的患病率高于儿童(10.0%比 3.9%;P < 0.001),高血压(7.2%比 1.3%;P < 0.001)和骨质疏松症(10.2%比 1.9%;P < 0.001)也是如此。2017 年超过 65%的 CF 住院患者年龄超过 18 岁。

结论

因 CF 住院的成年人数量正在增加,且 CF 患者出现了与年龄相关的合并症。需要准备好并能够满足成年人医疗保健需求的提供者需要为这一独特且不断增长的患者群体做好准备。

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