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

2017 ◽  
Vol 88 (5) ◽  
pp. 339-346 ◽  
Author(s):  
R. Louise Rushworth ◽  
Georgina L. Chrisp ◽  
Benjamin Dean ◽  
Henrik Falhammar ◽  
David J. Torpy

Background/Aims: To determine the burden of hospitalisation in children with adrenal insufficiency (AI)/hypopituitarism in Australia. Methods: A retrospective study of Australian hospitalisation data. All admissions between 2001 and 2014 for patients aged 0–19 years with a principal diagnosis of AI/hypopituitarism were included. Denominator populations were extracted from national statistics datasets. Results: There were 3,779 admissions for treatment of AI/hypopituitarism in patients aged 0–19 years, corresponding to an average admission rate of 48.7 admissions/million/year. There were 470 (12.4%) admissions for an adrenal crisis (AC). Overall, admission for AI/hypopituitarism was comparable between the sexes. Admission rates for all AI, hypopituitarism, congenital adrenal hyperplasia (CAH), and “other and unspecified causes” of AI were highest among infants and decreased with age. Admissions for primary AI increased with age in both sexes. Males had significantly higher rates of admission for hypopituitarism. AC rates differed by both sex and age group. Conclusion: This nationwide study of the epidemiology of hospital admissions for a principal diagnosis of AI/hypopituitarism shows that admissions generally decreased with age; males had higher rates of admission for hypopituitarism; females had higher rates of admission for CAH and “other and unspecified causes” of AI; and AC incidence varied by age and sex. Increased awareness of AI and AC prevention strategies may reduce some of these admissions.

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
R. Louise Rushworth ◽  
Henrik Falhammar ◽  
Craig F. Munns ◽  
Ann M. Maguire ◽  
David J. Torpy

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.


Author(s):  
Morten Munkvik ◽  
Ingvild Vatten Alsnes ◽  
Lars Vatten

Background: Epidemiological studies of COVID-19 with population based information may add to the knowledge needed to prioritise resources and advice on how restrictive measures should be targeted. This study provides admission rates to hospitals and intensive care units (ICU) in Norway, aiming to better understand the risk of severe COVID-19 infection. Methods: Data from official reports from The Norwegian Institute of Public Health (NIPH) and the Norwegian Directorate of Health were used to calculate admission rates to hospitals and to ICU per 100 000 inhabitants. We compared rates of hospitalisation between the four health regions and provide separate rates for Oslo. We also assessed national admissions to ICU stratified by age. Results: The admission rate in the south-eastern region was 3.1 per 100 000, and the rate for Oslo was 5.8. Compared to the western region (reference), the Oslo rate was 4.0 times (confidence interval (CI) 3.0-5.5) higher. In Norway as a whole, the rate of ICU admissions was 3.9 per 100 000, and in the age groups 60-69 and 70-79, ICU rates were 10.3 and 11.5, respectively. These rates were 9.5 (CI 6.3-14.3) and 10.6 (CI 6.9-16.2) times higher compared to people younger than 50 years. Conclusion: Hospital admissions due to Covid-19 are much higher in Oslo than anywhere else in Norway, and in the country as a whole, ICU admissions are highest among people 60-79 years of age. These results and more detailed data could provide better advice on how restrictions can be safely lessened.


2018 ◽  
Vol 14 (4) ◽  
pp. 417-421 ◽  
Author(s):  
Deanna Anderlini ◽  
Guy Wallis ◽  
Welber Marinovic

Background and aims Little data exist on the incidence of stroke in Australia. Our aim was to report age and sex disparities in hospital admission for stroke in Queensland, Australia's most populous northern state. Methods We identified all patients admitted to hospital in Queensland with a diagnosis of stroke from January to December 2015. Results Among 25,776 admissions with a diagnosis of stroke or TIA and related sequelae, stroke was the principal diagnosis in 11,072 cases of whom 5270 (47.60%) were first-ever stroke. Based on incidents per 100,000 population per year, the crude annual admission rate for first-ever strokes was 110 (95% CI, 107 to 113), 120 (95% CI, 115 to 124) for men and 101 (95% CI, 97 to 105) for women. The corresponding rates adjusted to the world population were 69 (95% CI, 52 to 85), and 88 (95% CI, 70 to 107) adjusted to the European population. Gender and age-adjusted incidence was greater for men than women in all age-groups, except those aged 30–34 years, where occurrence was 10 for men and 16 for women. Conclusions Based on the outcomes, hospital admission for stroke occurs less frequently in Queensland than in other regions of Australia. Men generally show a higher rate of hospitalization than women, with the notable exception of women aged 30–34, for whom the trend reverses.


2021 ◽  
pp. 140349482110008 ◽  
Author(s):  
Jon Helgeland ◽  
Kjetil E. Telle ◽  
Mari Grøsland ◽  
Beate M. Huseby ◽  
Siri Håberg ◽  
...  

Background: In mid-March 2020, the Norwegian government implemented measures to contain the coronavirus disease 2019 (COVID-19) pandemic, and hospitals prepared to handle an unpredictable inflow of patients with COVID-19. Aim: The study was performed to describe the changes in hospital admissions during the first phase of the pandemic. Methods: The Norwegian Institute of Public Health established a national preparedness register with daily updates on COVID-19 cases and the use of health services. We used individual-level information on inpatients from the electronic journal systems for all hospitals in Norway to estimate daily hospital admissions. Results: Before the onset of the pandemic in March, there was an average of 2400 inpatient admissions per day in Norway, which decreased to approximately 1500 in the first few days after lockdown measures were implemented. The relative magnitudes of the decreases were similar in men and women and across all age groups. The decreases were substantial for both elective (54%) and emergency (29%) inpatient care. The admission rate gradually increased and reached pre-pandemic levels in June. However, the reductions in admissions for pneumonia and chronic obstructive pulmonary disease seemed to persist. Conclusions: The elective and emergency inpatient admission rates were substantially reduced a few days after the pandemic response measures were implemented. The ways in which the lack or postponement of care may have affected the health and well-being of patients is an important issue to be addressed in future research.


Author(s):  
Iván Area ◽  
Henrique Lorenzo ◽  
Pedro J. Marcos ◽  
Juan J. Nieto

In this work we look at the past in order to analyze four key variables after one year of the COVID-19 pandemic in Galicia (NW Spain): new infected, hospital admissions, intensive care unit admissions and deceased. The analysis is presented by age group, comparing at each stage the percentage of the corresponding group with its representation in the society. The time period analyzed covers 1 March 2020 to 1 April 2021, and includes the influence of the B.1.1.7 lineage of COVID-19 which in April 2021 was behind 90% of new cases in Galicia. It is numerically shown how the pandemic affects the age groups 80+, 70+ and 60+, and therefore we give information about how the vaccination process could be scheduled and hints at why the pandemic had different effects in different territories.


Author(s):  
Hansol Chang ◽  
Ji Young Min ◽  
Dajeong Yoo ◽  
Se Uk Lee ◽  
Sung Yeon Hwang ◽  
...  

Surveillance of injury patterns and comparisons among different age groups help develop a better understanding of recent injury trends and early prevention. This study conducted a national surveillance of injury by age group. Data were collected retrospectively from Emergency Department-Based Injury In-Depth Surveillance (EDIIS) in South Korea, between January 2011 and December 2017. Patients were divided into the following four groups by age: Group 1–18 to 34 years, Group 2–35 to 49 years, Group 3–50 to 64 years, and Group 4—≥65 years. A total of 1,221,746 patients were included in the study. Findings revealed that, each year, the injury rate increased in the population aged ≥65 years. The place and mechanism of injury in Group 3 were similar to those in younger age groups, while injury outcomes and injured body parts were similar to those in Group 4. Further, hospital admission rate, ICU admission rate, hospital death, traumatic brain injury, and injury severity increased with an increase in age. In our study, each age group showed diverse characteristics pertaining to the mechanism, place, time, and outcomes of injuries. Interestingly, Group 3, which represented the late middle age, exhibited increased vulnerability to injury, and emerged as a gray zone between the young and old age groups. Therefore, different injury prevention methods are needed for each age group. Specifically, early prevention methods need to be implemented from the late middle age to improve the old age group’s injury outcomes.


2015 ◽  
Vol 1 (4) ◽  
pp. 184 ◽  
Author(s):  
Caroline Magri ◽  
Robert Xuereb ◽  
Sandra Distefano ◽  
Neville Calleja ◽  
Victor Grech

Objectives: The introduction of laws that make indoor public areas and workplaces smoke-free has resulted in a significant<br />reduction in the incidence of acute coronary syndromes (ACS). Malta was the second European country to introduce the<br />smoking ban legislation in April 2004. The purpose of the study was to investigate the impact of the smoking ban in Malta on<br />ACS morbidity and mortality.<br />Methods: The number of ACS hospital admissions and the number of cardiovascular deaths were retrospectively analysed.<br />The annual data for 5 years prior to and following the introduction of the Tobacco Act were obtained according to age-groups<br />for both genders. Poisson regression analyses were performed to assess for decline in ACS admission and cardiovascular<br />death.<br />Results: The ACS admission rate increased throughout the 5 years following the introduction of the smoking ban. There was<br />no change in mortality rate in the 5 years following the legislation, except in 2007 when a small but significant decline was<br />noted.<br />Conclusions: The Malta smoking ban did not have a significant impact on cardiovascular mortality and ACS admissions<br />rates, indicating the need for proper enforcement of the public smoking ban and increase in public awareness regarding the<br />adverse effects of smoking.<br />Key words: Coronary heart disease; Mortality; Prevention; Smoking.


2010 ◽  
Vol 67 (6) ◽  
pp. 473-479 ◽  
Author(s):  
Zoran Milosevic ◽  
Dragan Bogdanovic ◽  
Sladjana Jovic ◽  
Aleksandra Stankovic ◽  
Suzana Milutinovic ◽  
...  

Background/Aim. In studies that investigate the health effects of short-term air pollution exposure, population-wide changes in acute outcomes such as mortality, hospital admissions and healthcare visits are linked to short-term variations in ambient pollutant concentrations. The aim of this study was to estimate the association between daily outdoor black smoke and sulphur dioxide levels and hospital admissions for cardiovascular and respiratory diseases in Nis, within a period 2001-2005. Methods. A time series analysis was performed using separated regression models for each pollutant and disease group, by age groups and population as a whole. The effects of copollutant, meteorological factors and cyclic oscillations in hospitalization numbers were controlled. Results. A significant increase in hospital admissions was associated with a 10 ?g/m3 increase in the concentration of black smoke, for cardiovascular diseases: 3.14% (< 0.01) in children and youth under 19 years of age, 1.85% (< 0.001) in 19-64 age group, and 0.84% (< 0.05) in all ages, and for respiratory diseases: 1.77% (< 0.05) in 19-64 age group, and 0.91% (< 0.05) in all ages. The effects on hospitalizations for respiratory diseases in children and youth under 19 years of age, and for cardiovascular and respiratory diseases in the elderly were not statistically significant. The increase of sulphur dioxide level was associated with the increased number of hospitalizations, for both cardiovascular and respiratory diseases in all age groups, but the influence was not statistically significant. Conclusion. Outdoor pollutants concentrations in urban area of Nis were below regulated limit values during most of the investigated period days but it is shown that even such a level of pollution has a significant effect on hospital admissions for cardiovascular and respiratory diseases.


Neurology ◽  
2018 ◽  
Vol 91 (23 Supplement 1) ◽  
pp. S22.2-S22
Author(s):  
Amy Linabery ◽  
Kara Seaton ◽  
Alicia Zagel ◽  
Alicen Spaulding ◽  
Gretchen Cutler ◽  
...  

BackgroundIncreased concussion rates in US youth have been documented since 2000. Concomitant rises in healthcare utilization for concussion are likely attributable to public health, media, and legislative initiatives aimed at increasing public awareness of the importance of seeking medical attention after injury. Utilization trends in young children have not been well-documented, however.ObjectiveTo characterize recent secular trends in pediatric emergency department (ED) encounters for concussion by 4-year age group.MethodsUsing Children's Hospital Association's Pediatric Health Information System data, we examined a retrospective cohort of patients aged 2–17 years with an ED encounter for concussion at 22 US pediatric hospitals with continuous data between 2008 and 2017. Average annual change in rates of ED visits for concussion and sports-/recreation-related concussion, imaging, and admissions were estimated via weighted least-squares regression.ResultsED encounters with a primary indication of concussion comprised 0.8% (n = 86,393) of all ED encounters in 2008–2017. Over time, ED concussion visits in 6–17-year-olds increased by 0.5–1.1 per 1,000 ED encounters per year (all Ptrend< 0.0001), while rates among 2-5-year-olds remained stable (Ptrend = 0.72). Rates for sports-/recreation-related concussions increased significantly across all age groups (<0.0001 ≤ Ptrend ≤ 0.01). Absolute number undergoing any imaging increased in all age groups; however, due to increased ED concussion encounters, the rate of imaging decreased overall (−29.7/1,000 ED concussion encounters/year; Ptrend < 0.0001) and across all age groups; the imaging rate decreased less for 2-5-year-olds (−19.6/1,000 encounters/year; Ptrend < 0.0001). Likewise, admission rates declined significantly over time overall (−10.1/1,000 encounters/y; Ptrend = 0.0006) and for all age groups.ConclusionsED concussion encounter rates in US youth aged 6–17 years continue to increase at pediatric hospitals, suggesting awareness efforts have been effective. Conversely, imaging and admission rates have decreased, indicating efforts to curtail unnecessary irradiation and intervention have also been successful. Trends in 2-5-year-olds were somewhat different from older youth and should be explored further.


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