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Evaluation of referrals for short stature: A retrospective chart review

David Yue1,2,3, Michael R Miller3,4, Cheril L Clarson1,2,3

  • 1Children's Hospital, London Health Sciences Centre, London, Ontario.

Paediatrics & Child Health
|April 19, 2019
PubMed

Insights

Height velocity (HV) is a key indicator for diagnosing pediatric endocrine disorders (PED) in children with short stature. Prompt access to previous measurements aids in calculating HV, leading to faster diagnosis and treatment.

Area of Science:

  • Pediatric Endocrinology
  • Growth Disorders

Background:

  • Short stature referrals to pediatric endocrine clinics are frequent.
  • Height velocity (HV) is crucial for evaluating short stature, as growth deceleration may indicate a pediatric endocrine diagnosis (PED).
  • Previous growth measurements are essential for timely HV calculation.

Purpose of the Study:

  • To assess the availability of prior growth measurements for short stature referrals.
  • To identify predictors of a pediatric endocrine diagnosis (PED).

Main Methods:

  • Retrospective chart review of short stature referrals (2008-2014).
  • Standard protocol involved requesting previous measurements from referring physicians.
  • Analysis of 286 patient charts (aged 11 months to 18 years).

Main Results:

  • Previous measurements were available for 72.4% of patients.
  • A pediatric endocrine diagnosis (PED) was identified in 44.8% of cases with available measurements.
  • Height velocity below the 25th percentile and height deficit greater than 2 standard deviations significantly increased the odds of a PED.

Conclusions:

  • Height velocity is a significant predictor of pediatric endocrine diagnoses.
  • An effective referral screening protocol improved the availability of crucial growth data.
  • Access to previous measurements facilitates HV calculation, potentially reducing diagnostic and management delays.
Abstract

Keywords:
Growth chartsPaediatric endocrine diagnosisShort stature referrals

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