(123) Trends in Adolescent Inpatient Admission for Pelvic Inflammatory Disease

Background: Pelvic Inflammatory disease (PID) is one of the most common reasons for hospitalization among female adolescents. This study aims to better understand demographic and epidemiologic trends of adolescent patients admitted with PID, especially when compared to adults.

Methods: This is a retrospective cohort study using the National Inpatient Sample. Data from 2016 to 2021 was collected for all patients assigned female at birth treated in the inpatient setting for PID. This population was divided into adolescents (12-21 yo) and adults (>21 yo). Patients were identified using ICD-10 codes for PID. Data was analyzed using t-tests for continuous variables and Chi Square tests for categorical variables. IRB exemption was obtained.

Results: There were 287,365 hospital admissions for PID during this 6 year study period. Of these, 9.5% were adolescents (n=27,280). The proportion of adolescents remained relatively constant over time, while the proportion of adults decreased significantly (18.9% to 15.1%).

Patients identified as White made up the largest group by race among both adolescents (38.1%, P< 0.0001) and adults (44.6%, P< 0.0001). However, compared to their adult counterparts, there was a greater proportion of Black (31.3% vs. 26.9%, P< 0.0001) and Hispanic (19.8% vs. 17.3%, P< 0.0001) patients among adolescents. The majority of adolescents had Medicaid insurance (54.3%, P< 0.0001), while adults primarily had private insurance (50.3%, P< 0.0001). While the majority of adolescent admissions were in the South and Midwest regions of the country, adults were mostly hospitalized in the South and West regions. Among both groups, approximately three fourths of patients were admitted to urban teaching hospitals, as opposed to rural or non-teaching hospitals (79.6% and 72.6%, respectively, P< 0.0001). See Table 1.

With respect to comorbidities, adolescents were significantly less likely to be obese compared to adults (5.2% vs. 10.9%, P< 0.0001). Adolescent age was also associated with an increased risk of developing sepsis during hospitalization (11.8% vs. 10.4%, P< 0.0012). With respect to hospital discharge and cost, adolescents had a shorter average length of hospital stay (3.7 vs. 3.9 days, P=0.0160) and lower total admission charges ($42,994 vs. $55,237, P< 0.0001). See Table 2.

Conclusions: PID remains a significant cause for hospitalization among adolescents with a stable rate of admission over time, despite admission rates decreasing for adults. Increased effort to screen adolescents for STIs and focus on early diagnosis of PID in the outpatient care setting may decrease the sequelae of the disease while saving costs associated with treatment and hospitalization.