ESPE Abstracts (2016) 86 P-P2-59

Hospitalisation in Children with Adrenal Insufficiency and Hypopituitarism: Is there a Differential Burden Between Boys and Girls and Between Age Groups?

R. Louise Rushwortha, Georgina Chrispa, Henrik Falhammarc,e & David Torpyb


aThe University of Notre Dame, Australia, Sydney, NSW, Australia; bEndocrine and Metabolic Unit, Royal Adelaide Hospital and University of Adelaide, Adelaide, SA, Australia; cDepartment of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden; dDepartment of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; eMenzies School of Health Research and Royal Darwin Hospital, Darwin, NT, Australia


Background: There is a paucity of information on the utilisation of hospital services by children and adolescents with adrenal insufficiency (AI) and hypopituitarism.

Objective and hypotheses: To determine the number of episodes of hospitalisation in children with adrenal insufficiency (AI) and hypopituitarism in Australia, and to analyse trends in these admissions.

Method: An analysis of all admissions to Australian hospitals in patients aged 0 to 19 years with AI and hypopituitarism over a 14 year period using an administrative database. Crude rates were calculated overall and for the age and sex specific groups. Poisson regression models were used to assess the significance of the observed differences.

Results: There were 3786 admissions for treatment of AI and hypopituitarism in patients aged 0–19 years, corresponding to an average admission rate of 48.8/million/year. Hypopituitarism comprised 40.1% of the admissions and 22.2% were for congenital adrenal hyperplasia (CAH). There were 470 (12.4%) admissions for an adrenal crisis (AC) and the incidence of adrenal crises increased significantly over the study (P<0.01). Overall, admission for AI was comparable between the sexes and 40.1% of the admissions were for children aged 0–4 years. Admission rates for AI, hypopituitarism, CAH and ‘Other and unspecified causes’ of AI were highest among infants and decreased with age. Admissions for Primary AI increased significantly with age. Males had higher rates of admission for hypopituitarism (P<0.01) but females had significantly rates of admission for CAH and ‘other and unspecified causes’ of AI.

Conclusion: In the age group 0–19 years, admissions for the combined causes of AI decreased with age, males had higher rates of admission for hypopituitarism and females had higher rates of admission for CAH and ‘other and unspecified causes’ of AI. Adrenal crises increased over the study.

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