Burden of Hospitalizations Due To Congenital Adrenal Hyperplasia in New England: Six Cohort Analysis of Pooled National In-Patient Database for 2016-2020

OBJECTIVES: To assess the burden of hospitalizations due to Congenital Adrenal Hyperplasia in New England, using the pooled national in-patient database from 2016 to 2020.

METHODS: The 2016-2020 National Inpatient Sample (NIS) real-world data sets were pooled and analyzed for hospitalizations due to Congenital Adrenal Hyperplasia in New England. Six cohorts were designed: (1) all hospitalizations, (2) above the 90th percentile by charges, (3) below the 90th percentile by charges, (4) above the 90th percentile by comorbidity score, (5) below the 90th percentile by comorbidity score and (6) death in the hospital. The comorbidity rates were assessed using three methods: the Charlson index, the Elixhauser method, and broad ICD-10 categories. Severe infections were assessed based on a previously reported list of infections.

RESULTS: From 2016 to 2020, there were an estimated 515 Congenital Adrenal Hyperplasia-related hospitalizations in New England. For the six cohorts mentioned above, the mean age was 29.05 (SD 24.33), 32.5 (SD 28.88), 28.68 (SD 23.94), 65.5 (SD 12.98), 25.98 (SD 22.52), 63.33 (SD 7.23) years, respectively. The mean hospital length of stay (LOS) was 7.65 (SD 18.45), 40.1 (SD 49.02), 4.16 (SD 3.92), 8.75 (SD 9.71), 7.56 (SD 19.03), 13.33 (SD 15.31) days, respectively. The mean total charges were $69913 (SD 206773), $475283 (SD 527050), $26325 (SD 21114), $152386 (SD 278748), $62968 (SD 199949), $300199 (SD 456407), respectively. The comorbidity score was 1.69 (SD 1.89), 2.9 (SD 3.07), 1.56 (SD 1.7), 6.38 (SD 1.3), 1.29 (SD 1.32), 6 (SD 1), respectively. The most common comorbid conditions were: Congestive Heart Failure, Cardiac Arrhythmias, Hypothyroidism, Renal Failure, Liver Disease, Obesity, Diabetes and Depression.

CONCLUSIONS: Analyses of pooled five-year real-world hospital records of Congenital Adrenal Hyperplasia in New England show that these patients pose a significant clinical and economic burden.