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Outcomes in hospitalisations of women with Turner syndrome compared to women without Turner syndrome

Part of: Metabolic

Published online by Cambridge University Press:  19 March 2021

Isani Singh ,
Lindsey M. Duca ,
David Kao ,
Kathryn C. Chatfield  and
Amber D. Khanna Open the ORCID record for Amber D. Khanna [Opens in a new window]
Isani Singh
Affiliation:
Department of Statistics, Harvard University, Cambridge, MA, USA
Lindsey M. Duca
Affiliation:
Colorado School of Public Health, Department of Epidemiology, University of Colorado | Aschutz Medical Center, Aurora, CO, USA
David Kao
Affiliation:
School of Medicine, Department of Medicine, Division of Cardiology, University of Colorado | Aschutz Medical Campus, Aurora, CO, USA
Kathryn C. Chatfield
Affiliation:
School of Medicine, Departments of Medicine and Pediatrics, Divisions of Cardiology, University of Colorado | Anschutz Medical Campus, Aurora, CO, USA
Amber D. Khanna*
Affiliation:
School of Medicine, Department of Medicine, Division of Cardiology, University of Colorado | Aschutz Medical Campus, Aurora, CO, USA
*
Author for correspondence: Amber Khanna MD, MS, Departments of Medicine and Pediatrics, 12401 E. 17th Ave, B132 Aurora, CO80045, USA. Tel: 720-848-6505; Fax: 720-848-5301. Email: Amber.Khanna@cuanschutz.edu
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Abstract

Objective:

To evaluate outcomes in patients with Turner Syndrome, especially those with cardiac conditions, compared to those without Turner syndrome.

Design:

Retrospective cohort study utilising hospitalisation data from 2006 to 2012. Conditional logistic regression models are used to analyse outcomes of interest: all-cause mortality, increased length of stay, and discharge to home.

Participants:

We identified 2978 women with Turner syndrome, matched to 11,912 controls by primary diagnosis.

Results:

Patients with Turner syndrome were more likely to experience inpatient mortality (odds ratio 1.44, 95% confidence interval 1.02–2.02, p = 0.04) and increased length of stay (OR 1.31, CI 1.18–1.46, p = 0.03) than primary diagnosis matched controls, after adjusting for age, race, insurance status, and Charlson comorbidity index. Patients with Turner syndrome were 32% less likely to be discharged to home (OR 0.68, CI 0.60–0.78, p < 0.001). When restricting the sample of patients to those admitted with a cardiac diagnosis, the likelihood of mortality (OR 3.10, CI 1.27–7.57, p = 0.01) and prolonged length of stay (OR 1.42, CI 1.03–1.95, p = 0.03) further increased, while the likelihood of discharge to home further decreased (OR 0.55, CI 0.38–0.80, p = 0.001) in Turner syndrome compared to primary diagnosis matched controls. Specifically, patients with congenital heart disease were more likely to have prolonged length of stay (OR: 1.53, CI 1.18–2.00, p = 0.002), but not increased mortality or decreased discharge to home.

Conclusions:

Hospitalised women with Turner syndrome carry a higher risk of adverse outcomes even when presenting otherwise similarly as controls, an important consideration for those treating them in these settings.

Keywords

Turner syndromecomorbiditymortalityoutcomes researchhospital admission
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 10 , October 2021 , pp. 1667 - 1674
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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