Evidence map›Paper›PMID 36593179›Full record

ArticleClinical endocrinology2023

Electrolyte abnormalities and stress dosing predict illness-related hospitalizations among infants and toddlers with congenital adrenal hyperplasia.

Teresa Tseng, Amy Seagroves, Veeraya K Tanawattanacharoen, Mark C Liang, Christina M Koppin, Madison Keenan, Elana Davidowitz, Eugene Nguyen, Sanjay Chand, Mitchell E Geffner and 2 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical endocrinology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 44% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 2 institutions in 1 country.

Teresa TsengDivision of Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, California, USA.
Amy SeagrovesDivision of Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, California, USA.
Veeraya K TanawattanacharoenDivision of Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, California, USA.
Mark C LiangDivision of Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, California, USA.
Christina M KoppinDivision of Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, California, USA.
Madison KeenanDivision of Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, California, USA.
Elana DavidowitzDivision of Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, California, USA.
Eugene NguyenChildren's Hospital Los Angeles, Los Angeles, California, USA.
Sanjay ChandChildren's Hospital Los Angeles, Los Angeles, California, USA.
Mitchell E GeffnerDivision of Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, California, USA.
Todd P ChangKeck School of Medicine of University of Southern California, Los Angeles, California, USA.
Mimi S KimDivision of Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, California, USA.ORCID 0000-0002-6266-3569
Children's Hospital of Los Angeles · USUniversity of Southern California · US

Funding

Brain and Adipose Contributors to Food Seeking in Youth with Adrenal HyperplasiaK23HD084735 · NICHD · CHILDREN'S HOSPITAL OF LOS ANGELES · PI KIM, MIMI SUSAN · 2016 to 2018
$474k
Effects of Androgen Excess on Lipid Distribution in Congenital Adrenal HyperplasiaR03HD101718 · NICHD · CHILDREN'S HOSPITAL OF LOS ANGELES · PI KIM, MIMI SUSAN · 2020 to 2021
$183k
NICHD NIH HHS K23 HD084735NICHD NIH HHS R03 HD101718
6 · The paper itself

Abstract

objectiveInfants and toddlers with classical congenital adrenal hyperplasia (CAH) are at high risk for morbidity/mortality arising from life-threatening adrenal crisis. Management of acute illnesses in CAH requires an understanding of factors leading to emergency department (ED) visits and hospitalizations in the first few years of life. We, therefore, examined adrenal crisis at prehospital and ED stages of illness in young children with CAH as they related to medical outcomes. PATIENTS AND

designRetrospective cohort study of 39 children with CAH due to 21-hydroxylase deficiency (0-4 years of age) and 27 age-matched controls. MEASUREMENTS: ED visit, acute illness symptoms (fever, vomiting, diarrhoea) and other characteristics (hospitalizations, administration of stress-dose hydrocortisone, electrolyte abnormalities).

resultsCAH infants and toddlers had significantly higher rates of ED visits (0.50 [0.25-0.88] per person-year) than controls (0 [0-0] per person-year; p < .001). Moreover, CAH children under 6 months old had significantly higher rates of ED visits compared with older ages. Only 50% (51/102) of illness-related ED visits in CAH children were preceded by the administration of either oral (46/51) or intramuscular (11/51) stress dosing by parents. A total of 10.8% of ED visits resulted in hospital admission. Controlling for age and 17-hydroxyprogesterone at diagnosis, electrolyte abnormalities and administration of parenteral hydrocortisone in the ED significantly predicted hospital admission. Receiving a hydrocortisone injection before the ED was a significant predictor of having electrolyte abnormalities.

conclusionsInfants 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.

Indexed as

Adrenal Hyperplasia, CongenitalAcute DiseaseAdolescentAdultChild, PreschoolElectrolytesHospitalizationHumansHydrocortisoneInfantRetrospective StudiesElectrolytesHydrocortisone21-hydroxylase deficiencyacute illnessadrenal insufficiencycongenital adrenal hyperplasiahospitalization

Identifiers

PMID36593179
PMCPMC10006318
OpenAlexW4313454608

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.