Incidence Of Slipped Capital Femoral Epiphysis Research Articles

The Effect of Human Growth Hormone Treatment on the Development of Slipped Capital Femoral Epiphysis: A Cohort Analysis With 6 Years of Follow-up.

Slipped capital femoral epiphysis (SCFE) is a common hip disorder in adolescents that can result in substantial complications, impacting the quality of life. Human Growth Hormone (HGH) administration may elevate the risk of SCFE, though the relationship remains unclear. Clarifying this association could enable better monitoring and earlier diagnosis of SCFE in patients receiving HGH. The aim of the study is to investigate the association between HGH administration and the incidence of SCFE. This retrospective cohort study utilized data from the TriNetX research database from January 2003 to December 2022. The study included 2 cohorts: an HGH cohort including 36,791 patients aged below 18 years receiving HGH therapy and a control group consisting of patients who did not receive HGH therapy. A 1:1 propensity score matching technique was employed to ensure comparability between the HGH and no-HGH cohorts. The primary outcome measure was the development of SCFE identified by International Classification of Diseases codes. For comparative analysis, both risk ratios (RR) and hazard ratios were computed to evaluate the association between HGH therapy and the development of SCFE. The HGH cohort had an increased risk of SCFE compared with the no-HGH cohort (RR: 3.5, 95% CI: 2.073, 5.909, P <0.001) and had an increased hazard of developing SCFE (hazard ratio: 2.627, 95% CI: 1.555, 4.437, P <0.001). Patients with higher exposure to HGH (defined as >10 prescriptions) had an RR of 1.914 (95% CI: 1.160, 3.159, P =0.010) when compared with their counterparts with ≤10 prescriptions. In the largest study to date, HGH administration was associated with an elevated risk of SCFE in children in a dose-dependent manner. Level III-therapeutic retrospective cohort study.

A New Look on the Epidemiology of Slipped Capital Femoral Epiphysis: A Topic Revisited

Background: Slipped capital femoral epiphysis (SCFE) is a common hip pathology affecting adolescents mostly in the rapid growth phase. Previous studies have presented epidemiological data to inform practitioners on its etiology to improve diagnosis, treatment, and prevention. However, in recent years national databases have been redesigned, which may change previously published information on SCFEs. The purpose of this study is to evaluate SCFE epidemiology using the 2019 Kids' Inpatient Database (KID) and HCUPnet, Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality, in conjunction with U.S. Census Data.Methods: The Kids' Inpatient Database (KID) reflects data on 5.9 million pediatric discharges in 2019 and was combined with U.S. Census data to produce epidemiologic data regarding SCFEs in the pediatric population. KID regional data was then overlayed with National Oceanographic and Atmospheric Administration (NOAA) data to assess the associations between climate patterns and UV indices with SCFE incidence.Results: Overall incidence of SCFE in the U.S. was 2.66/100,000 children 9-16 years of age. The average age at presentation with SCFE was 12.3 years with males being older at presentation (12.8 vs. 11.6 years; P<.001; r=0.34). Males were significantly more likely to develop a SCFE than females (OR 1.73; 95% CI, 1.51-1.97). Black patients were significantly more likely to present with a SCFE than all other races (OR 1.66; 95% CI, 1.40-2.97). Obesity (23.2%) was the most common metabolic and endocrine comorbidity followed by severe obesity (7.5%). Geographical regions with colder temperatures and lower UV indexes had higher SCFE rates, while regions with higher temperatures and higher UV indexes had lower SCFE rates.Conclusion: This study determined a lower SCFE incidence rate than previously reported but shows similar distributions of SCFEs amongst different races. Age of onset was increased compared to previous studies. The rate of obesity also continues to increase while the incidence of SCFEs has experienced a gradual decrease over time. It is plausible that environmental factors and race (skin tone) may have a more influential effect on the development of this pathology.Level of Evidence: III - Cross-sectional study of non-consecutive patientsKey Concepts•SCFE incidence rates are lower than previously reported.•Obesity continues to increase while SCFEs have remained stable.•Cold climate regions (with lower UV-indexes) may be a risk factor for SCFEs, while areas with hot climate regions (with higher UV-indexes) could be protective.

Socioeconomic Deprivation and its Associations With Follow-up Compliance After In Situ Pinning of Slipped Capital Femoral Epiphysis.

Slipped capital femoral epiphysis (SCFE) is a common cause of hip pain in adolescents and is most often treated by in situ screw fixation. Orthopaedic follow-up is critical after treatment for SCFE due to risks of complications and subsequent contralateral slip. Recent studies have shown that socioeconomic deprivation is associated with decreased fracture care compliance, but no studies have explored this relationship with SCFEs. The study aims to determine the relationship between socioeconomic deprivation and SCFE follow-up care compliance. This study included pediatric patients treated with in situ pinning of SCFE between 2011 and 2019 at a single tertiary-care urban children's hospital. Demographic and clinical information were obtained from electronic medical records. The Area Deprivation Index (ADI) was used to quantify the socioeconomic deprivation of each. Outcome variables included patient age and status of physeal closure at the most recent appointment, in addition to the length of follow-up (mo). Statistical relationships were evaluated using nonparametric bivariate analysis and correlation. We identified 247 evaluable patients; 57.1% were male, and the median age was 12.4 years. Most slips were stable (95.1%) and treated with isolated unilateral pinning (55.9%). Median length of follow-up was 11.9 months (interquartile range, 4.95 to 23.1) with median patient age at final visit of 13.6 years (interquartile range, 12.4 to 15.1). Only 37.2% of patients were followed until physeal closure. The mean ADI spread in this sample was similar to the national distribution. However, patients in the most deprived quartile were lost to follow-up significantly earlier (median, 6.5mo) than those in the least deprived quartile (median, 12.5mo; P <0.001). Throughout the entire cohort, there was a significant, inverse relationship between deprivation and follow-up length ( rs (238) = -0.3; P <0.001), with this relationship most pronounced in the most deprived quartile. In this sample, ADI spread was representative of national trends, and the incidence of SCFE was distributed evenly across deprivation quartiles. However, follow-up length does not mirror this relationship; increased socioeconomic deprivation is associated with an earlier loss to follow-up (often well before physeal closure). Level II-retrospective prognostic study.

Fate of patients with slipped capital femoral epiphysis (SCFE) in later life: risk of obesity, hypothyroidism, and death in 2,564 patients with SCFE compared with 25,638 controls

Background and purpose — Associations between obesity and slipped capital femoral epiphysis (SCFE) during adolescence are described; however, few studies report on the lifetime risk of obesity in patients with SCFE. In addition, with the obesity epidemic in children and adolescents, an increasing incidence of SCFE might be expected. An association of SCFE with hypothyroidism seems ambiguous, and the association between SCFE and depression and all-cause mortality has not yet been evaluated. This study investigates the associations of SCFE with obesity, hypothyroidism, depression, and mortality, and putative changes in the yearly incidence of SCFE.Patients and methods — 2,564 patients diagnosed with SCFE at age 5–16 diagnosed between 1964 and 2011 were identified in the Swedish Patient Register. These were matched for age, sex, and residency with unexposed control individuals. Cox regression models were fitted to estimate the risk of obesity, hypothyroidism, depression, and death, in exposed compared with unexposed individuals.Results — The risk of obesity (HR 9, 95% CI 7–11) and hypothyroidism (HR 3, CI 2–4) was higher in SCFE patients compared with controls. There was no increase in the risk of developing depression (HR 1, CI 1–1.3) in SCFE patients. In contrast, all-cause mortality was higher in SCFE patients than in controls (HR 2, CI 1–2). The incidence of SCFE did not increase over the past decades.Interpretation — Patients with SCFE have a higher lifetime risk of obesity and hypothyroidism and a higher risk of all-cause mortality compared with individuals without SCFE. These findings highlight the lifetime comorbidity burden of patients who develop SCFE in childhood, and increased surveillance of patients with a history of SCFE may be warranted. The incidence of SCFE did not increase over the last decades despite increasing obesity rates.

Higher BMI, Higher Risk of Slipped Capital Femoral Epiphysis

Research Article| February 01 2019 Higher BMI, Higher Risk of Slipped Capital Femoral Epiphysis AAP Grand Rounds (2019) 41 (2): 20. https://doi.org/10.1542/gr.41-2-20 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Higher BMI, Higher Risk of Slipped Capital Femoral Epiphysis. AAP Grand Rounds February 2019; 41 (2): 20. https://doi.org/10.1542/gr.41-2-20 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: body mass index procedure, epiphyses, slipped, obesity Source: Perry DC, Metcalfe D, Lane S, et al. Childhood obesity and slipped capital femoral epiphysis. Pediatrics. 2018; 142(5): e20181067; doi: https://doi.org/10.1542/peds.2018-1067Google Scholar Investigators from multiple UK institutions conducted a cohort study to assess the strength of association between childhood obesity and slipped capital femoral epiphysis (SCFE). The cohort was identified using a nationwide child health surveillance program in Scotland, as well as a data set that included 10% of the Scottish population. In both data sets, child demographics, height, and weight were routinely recorded at school entry (5–6 years old) by school nurses. Height and weight among a subgroup of cohort children at 11–12 years old were recorded in a third data set. The primary exposure was BMI, categorized as underweight (<5%), normal weight (5%–85%), overweight (≥85%–94%), mild/moderate obesity (≥95%–99%), or severe obesity (≥99%). The primary outcome was SCFE diagnosed between the ages of 6 and 18 years, as determined by ICD-10 codes in the Scottish Morbidity Record, a registry of patients discharged from all Scottish hospitals. Cohort children contributed to follow-up until they reached 18 years, received a diagnosis of SCFE, or the study period ended. Investigators calculated the incidence of SCFE by BMI category among children 5–6 years old and 11–12 years old. The risk of SCFE attributable to BMI was also calculated. There were 597,017 children 5–6 years old and 39,468 children 11–12 years old included in the analysis, with a total follow-up time of 4.26 million child-years. Among children 5–6 years old, 11.9% were overweight, and 9.2% were obese. Of those obese at 5–6 years old, 75% remained obese at 11–12 years old. There were 209 children diagnosed with SCFE. The incidence of SCFE in children 5–6 years old was 4.7 per 100,000 child-years of risk (95% CI, 4.1–5.4). Compared to children of normal weight at 5–6 years old, those who had severe obesity, had mild/moderate obesity, or were overweight had 5.9 (95% CI, 3.9–9.0), 3.8 (95% CI, 2.6–5.8), and 1.5 (95% CI, 0.9–2.3) times greater risk of developing SCFE, respectively. The risk of SCFE attributable to BMI at 5–6 years old was 78% among children with obesity and 31% among children who were overweight. The incidence of SCFE in children 11–12 years old was 23.8 per 100,000 child-years of risk (95% CI, 14.8–36.4), with a 17 times greater risk of developing SCFE (95% CI, 5.9–49.0) in those with severe obesity (vs normal BMI) at 11–12 years. The investigators conclude that childhood BMI is strongly associated with SCFE. Dr Hennrikus has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. Childhood obesity is a global health problem.1 SCFE is a disease that causes lifelong disability due to arthritis, pain, and leg length inequality.2,3 SCFE occurs through the histologic zone of hypertrophy in the open growth plate.4 The peak age for SCFE is around puberty.... You do not currently have access to this content.

Incidence and gender differences of slipped capital femoral epiphysis in the Netherlands from 1998–2010 combined with a review of the literature on the epidemiology of SCFE

The incidence of slipped capital femoral epiphysis (SCFE) among children living in the Netherlands has never been published. The national hospitalization registration system of the Netherlands was searched for the incidence of surgical procedures for SCFE in the Netherlands among different pediatric age groups between 1998 and 2010. International Classification of Diseases, 9th Revision codes were used. The incidence of surgical procedures for SCFE during the last decade was 11.6 per 100,000 children aged 5 to 19years. No statistical difference in the incidence of SCFE was found between boys and girls, although the incidence of SCFE did significantly increase in girls during the study period. Based on our analysis, the Netherlands appears to be the first country in which no difference in the incidence of SCFE among boys and girls has been reported. However, during the study period there has been a concomitant increase in the number of girls with SCFE.

Epidemiology and Demographics of Slipped Capital Femoral Epiphysis in Korea: A Multicenter Study by the Korean Pediatric Orthopedic Society

In 1979, slipped capital femoral epiphysis (SCFE) was rarely reported in Korea, although it is the most common hip disorder of adolescence in Western nations. However, because the number of reported cases of SCFE in Korea has increased a great deal since then, we performed a nationwide survey to ascertain its epidemiology and demographics in Korea. We reviewed the discharge databases for the period between January 1989 and December 2003 from 19 university hospitals across Korea. Recorded data included age at onset, sex, past medical history, height, weight, and type of slippage. We compared those data with national census data. The incidence data are reported as cases per 100,000 children between the ages of 10 and 14 years. Data for 231 patients (175 boys and 56 girls) were included in our survey. The average age at onset was 12 years 10 months in boys and 12 years in girls. The average annual incidence was estimated to be at least 0.499 for boys and 0.142 for girls for every 100,000 children between the ages of 10 and 14 years, which was lower than that of Western nations and Japan. The incidence showed a pattern of increments across each period. The mean body mass index was significantly higher in Korean patients with SCFE than in the population of the same age group without it. The incidence of SCFE in preadolescents in Korea has increased markedly since 1979, which may be related to increasing rates of obesity. Therapeutic, level 4.

Changing incidence of slipped capital femoral epiphysis

Obesity is thought to be an aetiological factor for slipped capital femoral epiphysis (SCFE). We analysed changes in the incidence of SCFE in Scotland over the last two decades. During this period rates of childhood obesity have risen substantially and evidence for a relationship between these changes and the incidence of SCFE was sought. We found that the incidence of SCFE increased from 3.78 per 100,000 children in 1981 to 9.66 per 100,000 in 2000 (R(2) = 0.715): a two and a half times increase over two decades. It was seen at a younger age, with a fall in the mean age at diagnosis from 13.4 to 12.6 years for boys (p = 0.007) and 12.2 to 11.6 for girls (p = 0.047). More children under eight years old were seen with SCFE in Scotland in the decade to 2000 than in the previous decade (p = 0.002, R(2) = 0.346). A close correlation was observed between rising childhood obesity over the last 20 years in Scotland and an increasing incidence of SCFE.