Electrolyte abnormalities and stress dosing predict illness‐related hospitalizations among infants and toddlers with congenital adrenal hyperplasia
Authors' conclusion
Infants and toddlers with classical CAH are at high risk for acute illness and hospitalizations and often do not receive adequate stress dosing before the ED.
Study context
- Population
- Infants and toddlers (0–4 years) with classical congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency and age-matched controls
- Participants
- 39 vs 27
- Exposure
- Children with CAH vs age-matched controls
- CAHn = 39
- Controlsn = 27reference
- Outcome
- Rate of ED visits
Methodological detailsage-matched controls
- Age-matched controls
Main finding
As reported in the abstract
P < 0.001
Observational data: associations, not effects.
Further findings
Emergency department (ED) visits by age in CAH
- CAH children <6 months had significantly higher ED visit rates than older ages
Stress dosing by parents before illness-related ED visits (CAH)
- ED visits preceded by stress dosing
- 50% (51/102)
- Oral stress dosing
- 46/51
- Intramuscular stress dosing
- 11/51
Hospital admission after ED visit
- ED visits resulting in admission
- 10.8%
- Electrolyte abnormalities and parenteral hydrocortisone in the ED significantly predicted admission
- Controlling for age and 17-hydroxyprogesterone at diagnosis
Predictor of electrolyte abnormalities
- Hydrocortisone injection before the ED significantly predicted electrolyte abnormalities
Original publication
Electrolyte abnormalities and stress dosing predict illness‐related hospitalizations among infants and toddlers with congenital adrenal hyperplasia. Clin Endocrinol (Oxf). Published 12 January 2023. doi:10.
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