Cargando…

Trends in hospital admissions for adrenal insufficiency in adolescents and young adults in the 21(st) century

BACKGROUND: Very little is known about the epidemiology of adrenal crises (AC) and adrenal insufficiency (AI) in adolescents and young adults. METHODS: Data on all admissions to Australian hospitals between 2000/1 to 2019/20 for a principal diagnosis of AI (including AC) in 10-24 year olds were extr...

Descripción completa

Detalles Bibliográficos
Autores principales: Chrisp, Georgina L., Quartararo, Maria, Torpy, David J., Falhammar, Henrik, Rushworth, R. Louise
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9530131/
https://www.ncbi.nlm.nih.gov/pubmed/36204108
http://dx.doi.org/10.3389/fendo.2022.986342
_version_ 1784801610103259136
author Chrisp, Georgina L.
Quartararo, Maria
Torpy, David J.
Falhammar, Henrik
Rushworth, R. Louise
author_facet Chrisp, Georgina L.
Quartararo, Maria
Torpy, David J.
Falhammar, Henrik
Rushworth, R. Louise
author_sort Chrisp, Georgina L.
collection PubMed
description BACKGROUND: Very little is known about the epidemiology of adrenal crises (AC) and adrenal insufficiency (AI) in adolescents and young adults. METHODS: Data on all admissions to Australian hospitals between 2000/1 to 2019/20 for a principal diagnosis of AI (including AC) in 10-24 year olds were extracted from a national repository. Age and sex-specific rates and age-adjusted rates were compared. FINDINGS: Over the study, there were 3386 admissions for a principal diagnosis of AI; 24.0% (n=812) were for an AC and 50·7% (n=1718) were for secondary AI. Age-adjusted AI admissions increased from 31·70/million in 2000/1 to 54·68/million in 2019/20 (p<0·0001). Age-adjusted AC admissions also increased, most notably in the second decade (from 5·80/million in 2010/11 to 15·75/million in 2019/20) (p<0·00001). Average AI and AC admission rates were comparable between the sexes, but rates increased significantly in females, especially in those aged 20 to 24 years, whose AC rate in 2019/20 (39·65/million) was significantly higher than the corresponding rate in 2000/1 (3·15/million) (p<0·00001). Average age-adjusted SAI admission rates were higher in males (23·92/million) than females (15·47/million) (p<0·00001). However, SAI admission rates increased only among females (from 11·81/million to 22·12/million in 2019/20), with an increase in 20-24 year old females in the second decade from 5·07/million in 2010 to 20·42/million (p<0·00001). Age adjusted admissions for congenital adrenal hyperplasia, primary AI (PAI) and drug-induced AI did not change significantly over the study. INTERPRETATION: AC/AI admissions increased over the first two decades of this century in the emerging adult population, particularly among females who also experienced a marked increase in AC admission rates, most evident in the second decade. Although uncertain, possible explanations include: dose of glucocorticoid replacement; non-adherence to therapy; psychosocial factors; and difficulty in transition to adult services. Admissions for SAI also increased, while rates of PAI and CAH remained constant.
format Online
Article
Text
id pubmed-9530131
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-95301312022-10-05 Trends in hospital admissions for adrenal insufficiency in adolescents and young adults in the 21(st) century Chrisp, Georgina L. Quartararo, Maria Torpy, David J. Falhammar, Henrik Rushworth, R. Louise Front Endocrinol (Lausanne) Endocrinology BACKGROUND: Very little is known about the epidemiology of adrenal crises (AC) and adrenal insufficiency (AI) in adolescents and young adults. METHODS: Data on all admissions to Australian hospitals between 2000/1 to 2019/20 for a principal diagnosis of AI (including AC) in 10-24 year olds were extracted from a national repository. Age and sex-specific rates and age-adjusted rates were compared. FINDINGS: Over the study, there were 3386 admissions for a principal diagnosis of AI; 24.0% (n=812) were for an AC and 50·7% (n=1718) were for secondary AI. Age-adjusted AI admissions increased from 31·70/million in 2000/1 to 54·68/million in 2019/20 (p<0·0001). Age-adjusted AC admissions also increased, most notably in the second decade (from 5·80/million in 2010/11 to 15·75/million in 2019/20) (p<0·00001). Average AI and AC admission rates were comparable between the sexes, but rates increased significantly in females, especially in those aged 20 to 24 years, whose AC rate in 2019/20 (39·65/million) was significantly higher than the corresponding rate in 2000/1 (3·15/million) (p<0·00001). Average age-adjusted SAI admission rates were higher in males (23·92/million) than females (15·47/million) (p<0·00001). However, SAI admission rates increased only among females (from 11·81/million to 22·12/million in 2019/20), with an increase in 20-24 year old females in the second decade from 5·07/million in 2010 to 20·42/million (p<0·00001). Age adjusted admissions for congenital adrenal hyperplasia, primary AI (PAI) and drug-induced AI did not change significantly over the study. INTERPRETATION: AC/AI admissions increased over the first two decades of this century in the emerging adult population, particularly among females who also experienced a marked increase in AC admission rates, most evident in the second decade. Although uncertain, possible explanations include: dose of glucocorticoid replacement; non-adherence to therapy; psychosocial factors; and difficulty in transition to adult services. Admissions for SAI also increased, while rates of PAI and CAH remained constant. Frontiers Media S.A. 2022-09-20 /pmc/articles/PMC9530131/ /pubmed/36204108 http://dx.doi.org/10.3389/fendo.2022.986342 Text en Copyright © 2022 Chrisp, Quartararo, Torpy, Falhammar and Rushworth https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Endocrinology
Chrisp, Georgina L.
Quartararo, Maria
Torpy, David J.
Falhammar, Henrik
Rushworth, R. Louise
Trends in hospital admissions for adrenal insufficiency in adolescents and young adults in the 21(st) century
title Trends in hospital admissions for adrenal insufficiency in adolescents and young adults in the 21(st) century
title_full Trends in hospital admissions for adrenal insufficiency in adolescents and young adults in the 21(st) century
title_fullStr Trends in hospital admissions for adrenal insufficiency in adolescents and young adults in the 21(st) century
title_full_unstemmed Trends in hospital admissions for adrenal insufficiency in adolescents and young adults in the 21(st) century
title_short Trends in hospital admissions for adrenal insufficiency in adolescents and young adults in the 21(st) century
title_sort trends in hospital admissions for adrenal insufficiency in adolescents and young adults in the 21(st) century
topic Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9530131/
https://www.ncbi.nlm.nih.gov/pubmed/36204108
http://dx.doi.org/10.3389/fendo.2022.986342
work_keys_str_mv AT chrispgeorginal trendsinhospitaladmissionsforadrenalinsufficiencyinadolescentsandyoungadultsinthe21stcentury
AT quartararomaria trendsinhospitaladmissionsforadrenalinsufficiencyinadolescentsandyoungadultsinthe21stcentury
AT torpydavidj trendsinhospitaladmissionsforadrenalinsufficiencyinadolescentsandyoungadultsinthe21stcentury
AT falhammarhenrik trendsinhospitaladmissionsforadrenalinsufficiencyinadolescentsandyoungadultsinthe21stcentury
AT rushworthrlouise trendsinhospitaladmissionsforadrenalinsufficiencyinadolescentsandyoungadultsinthe21stcentury