Researchers compile available information on the symptoms, diagnosis, radiological evidence, and treatment of Scurvy, a disease caused by the severe deficiency of vitamin C (ascorbic acid). They further conducted a retrospective investigation of pediatric patients from the United States (US) National Inpatient Sample Database (n = 19,413,465) between 2016 and 2020. Their findings highlight an alarming trend – in the span of just five years, the incidence of Scurvy in children more than tripled from 8.2 to 26.7 cases per 100,000.
More than half (64.2%) of scurvy patients were found to suffer from concomitant autism spectrum disorder, with male obese individuals, especially those in the lowest income quartiles, representing the highest-risk population. This study highlights the need for pediatricians and care providers to be aware of the potential for scurvy diagnoses, especially in patients with risk factors presenting vague musculoskeletal symptoms.
Study
In addition to the above-summarized review of scurvy diagnoses and treatment, the present study further comprises a retrospective investigation of the incidence and risk factors associated with Scurvy in the United States (US). Data for the study was derived from the Healthcare Cost and Utilization Project National Inpatient Sample (HCUP-NIS), the US's largest publicly available all-payer inpatient care database, representing approximately 20% of all inpatient documentation nationwide. Study inclusion criteria included all patients under 18 years of age between 2016 and 2020.
Data collection comprised demographic data (age, sex, ethnicity and race, household income, and insurance status) and medical data (including International Classification of Diseases [ICD-10] codes for scurvy or comorbidity identification). Patients identified as having Scurvy were compared with the general inpatient population using statistical analysis comprising analysis of variance (ANOVA) or chi-square tests (with Kendall tau).
Results
Nineteen million four hundred thirteen thousand four hundred sixty-five patients met the study inclusion criteria for the period under investigation and were included in statistical analysis. Of these, 265 individuals were diagnosed with Scurvy. Time series analyses revealed that during the course of the five years under study, the incidence of Scurvy increased from 8.2 per 100,000 (2016) to 26.7 per 100,000 children (2020). Population demographic data revealed that the mean age of scurvy patients was 2.15 years, with most being male (69.8%) and belonging to the lowest economic quartile (36.5%).
Concurrent diagnostic analyses revealed that Scurvy was frequently manifested in patients with autism spectrum disorder (ASD; 64.2%), cerebral palsy (5.7%), vitamin D deficiency (50.9%), and anemia (62.3%). Scurvy was also concurrently associated with abnormal weight gain – 7.6% and 3.8% of scurvy patients were found to be obese or morbidly obese, respectively. Compared to inpatients without the condition, scurvy patients were observed to experience substantially higher inpatient days (10.83 vs. 4.05) and hospitalization costs ($163,415.90 vs. $30,552.73), especially alarmingly given the low-income risk factor associated with the disease.
Conclusion
Despite being written off as an ancient disease or one restricted to the underdeveloped world, pediatric Scurvy seems to be making a comeback even in developed nations like the US. The present study highlights that in a span of just five years between 2016 and 2020, scurvy incidence more than tripled in the documented inpatient population. Younger male individuals, particularly those from low-income households, were found to represent the highest-risk populations in the nation, with ASD, anemia, and obesity identified as common concurrent diagnoses.
These findings suggest that pediatricians, orthopedic physicians, and caregivers need to be aware of the looming risk of rising scurvy incidence and include the disease in their workup differential, potentially saving these children and their families from prolonged hospitalizations, adverse musculoskeletal outcomes, and substantial hospitalization costs.
Source:
https://www.news-medical.net/news/20240719/Scurvy-on-the-rise-in-the-United-States-Pediatric-cases-triple-in-five-years.aspx