National Trends of Hospitalizations in Cystic Fibrosis Highlight a Need for Pediatric to Adult Transition Clinics
Mitchell L Ramsey1, Luis F Lara1, Cheryl E Gariepy
1From the Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center.
Insights
Hospitalizations for cystic fibrosis (CF) are increasingly affecting adults, who are also developing age-related conditions. Healthcare providers must prepare for this growing adult CF population and their complex needs.
Area of Science:
- Pulmonology
- Internal Medicine
- Geriatrics
Background:
- Cystic Fibrosis (CF) is a genetic disorder primarily affecting the lungs and digestive system.
- Advancements in CF care have led to increased survival rates, with a growing adult population.
- The emergence of age-related comorbidities in adults with CF is a significant clinical concern.
Purpose of the Study:
- To investigate the changing demographics of cystic fibrosis hospitalizations.
- To determine the prevalence of age-related comorbidities in hospitalized adults with CF.
- To assess trends in CF hospitalizations over time.
Main Methods:
- Retrospective analysis of the Nationwide Inpatient Sample (2002-2017).
- Inclusion criteria: hospitalizations with a principal diagnosis of cystic fibrosis.
- Analysis of patient age at discharge and comorbidity prevalence, using the Cochran-Armitage test for trend significance.
Main Results:
- The mean age of hospitalized CF patients increased from 19.7 to 23.0 years between 2002 and 2017.
- Comorbidities like congestive heart failure, substance abuse, and chronic kidney disease were over 10 times more prevalent in adults than children.
- In 2017, over 65% of CF hospitalizations were for individuals older than 18 years.
Conclusions:
- Adults with cystic fibrosis are increasingly hospitalized and developing age-related comorbidities.
- Healthcare systems must adapt to manage the growing and complex needs of the adult CF population.
- Specialized adult care is crucial for this unique and expanding patient demographic.
Objectives:
We hypothesized that hospitalizations in cystic fibrosis (CF) would reflect the development of age-related comorbidities.
Methods:
A retrospective analysis was performed using the Nationwide Inpatient Sample (2002-2017). Hospitalizations for which the principal diagnosis was CF were analyzed regarding age at discharge and presence of comorbidities. Trends were assessed for significance using the Cochran-Armitage test.
Results:
The mean age of patients hospitalized for CF increased from 19.7 years in 2002 to 23.0 years in 2017 (P = 0.017). Several comorbidities are more than 10 times more prevalent among adults as compared with children, including congestive heart failure, substance abuse, and chronic kidney disease (P < 0.001). In addition, diabetes with chronic complications was more prevalent in adults than children (10.0% vs 3.9%; P < 0.001), as was hypertension (7.2% vs 1.3%; P < 0.001) and osteoporosis (10.2% vs 1.9%; P < 0.001). More than 65% of CF hospitalizations in 2017 were in individuals older than 18 years.
Conclusions:
Hospitalizations for adults with CF are increasing, and individuals with CF are developing age-related comorbidities. Providers equipped to manage the health care needs of adults need to be ready and able to care for this unique and growing patient population.
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