Changing Pattern of Pediatric Endocrinology Referrals Over Two Decades: A Study From a Tertiary Center in Western India.

Introduction Understanding the pediatric endocrinology referral pattern is important for primary care clinicians and pediatric endocrinologists to optimize patient care, facilitate continuous medical education, and upgrade resources. This study analyzed the pattern of these referrals over a span of one year each, two decades apart, and the difference between the referral reasons and final diagnoses. Methods A retrospective analysis was conducted on demographic details and referral reasons to a pediatric endocrine clinic in a tertiary care hospital in Western India at two time intervals two decades apart (2002-2003 and 2022-2023). The referral reasons were categorized into 14 classes as per the International Classification of Pediatric Endocrinology Diagnoses (ICPED) 2016. Results Data of 2595 patients (920 (35.4%) from 2002-2003 and 1675 (64.5%) from 2022-2023) were studied. The most common reason for referral was short stature without gender bias. Disorders of puberty and obesity were the second and third most common reasons for referral. There was almost a two-fold rise in the total referrals over two decades, with a significant rise in females referred for short stature and disorders of puberty. There was a discrepancy between the final diagnosis and referral reason, predominantly in patients referred for micropenis, gynecomastia, and obesity. Conclusion We report pediatric endocrine referral patterns two decades apart, revealing a shift in the number of referrals with minor shifts in the referral reasons. A gap exists in recognizing symptoms and possible causes at the primary care level. These findings highlight the need for focused medical education and awareness among primary care clinicians.