Changing Pattern of Paediatric Endocrinology Referrals over two decades: A Retrospective Study from a Tertiary Centre in Western India

IntroductionUnderstanding the paediatric endocrinology referral pattern is important for primary care clinicians and paediatric endocrinologists to optimise patient care, facilitate continuous medical education and to upgrade resources. This study analysed the pattern of these referrals over a year, the change in referral trends 2 decades apart and the discrepancy between the referral reasons and final diagnoses. MethodsA retrospective analysis was conducted on demographic details and referral reasons to paediatric endocrine clinic in a tertiary care hospital in Western India at 2-time intervals 2 decades apart (2002-03 and 2022-23). The referral reasons were categorised into 14 classes as per International classification of paediatric endocrinology diagnoses (ICPED) 2016. ResultsData of 2595 patients (920 from 2002-03 and 1675 from 2022-23) was studied. The commonest reason for referral was Short Stature with no gender bias. Disorders of Puberty and Obesity were the 2nd and 3rd commonest reasons for referral. There was almost a 2-fold rise in the total number of referrals over 2 decades with a significant rise in females referred for Short Stature and Disorders of Puberty. There was a discrepancy between the final diagnosis and referral reason, predominantly in patients referred for Micropenis, Gynaecomastia and Obesity ConclusionWe report paediatric endocrine referral pattern over two decades, revealing a shift in the number of referrals but not a major shift in the referral reasons. A gap exists in recognizing symptoms and possible cause at the primary care level. These findings highlight the need for focused medical education and awareness among primary care clinicians.