National Trends of Hospitalizations in Cystic Fibrosis Highlight a Need for Pediatric to Adult Transition Clinics

Pancreas. 2021 May-Jun;50(5):704-709. doi: 10.1097/MPA.0000000000001815.

Abstract

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.

MeSH terms

  • Adult
  • Age Factors
  • Child
  • Comorbidity
  • Cystic Fibrosis / diagnosis
  • Cystic Fibrosis / mortality
  • Cystic Fibrosis / therapy*
  • Databases, Factual
  • Female
  • Health Care Costs / trends
  • Health Resources / trends
  • Hospital Mortality / trends
  • Hospitalization / trends*
  • Humans
  • Inpatients
  • Length of Stay / trends
  • Male
  • Patient Admission / trends
  • Prevalence
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Transition to Adult Care / trends*
  • United States / epidemiology
  • Young Adult