Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 May;24(2):e74-e77.
doi: 10.1093/pch/pxy079. Epub 2018 Jun 13.

Evaluation of referrals for short stature: A retrospective chart review

David Yue  1   2   3 , Michael R Miller  3   4 , Cheril L Clarson  1   2   3
Affiliations

Evaluation of referrals for short stature: A retrospective chart review

David Yue et al. Paediatr Child Health. 2019 May.

Abstract

Background: Referrals to paediatric endocrine clinics for short stature are common. Height velocity (HV) is an essential component of the evaluation of short stature as growth deceleration often reflects an underlying paediatric endocrine diagnosis (PED). Access to previous measurements facilitates prompt calculation of HV.

Objective: To determine the availability of previous measurements at time of referral for short stature and to determine predictors of a PED.

Methods: A retrospective chart review was performed on all referrals for short stature to a single paediatric endocrinologist between January 2008 and December 2014. Standard practice following receipt of a referral for short stature included repeated requests to the referring physician for previous measurements.

Results: A total of 324 charts of patients aged 11 months to 18 years were reviewed and 286 were eligible for inclusion. Previous measurements were available in 72.4%, and 44.8% of these were found to have a PED. There was a significant relation between HV<25th percentile and a PED (P<0.0001) and between height deficit (HD) and a PED (P<0.0001). Logistic regression analysis showed that a HV<25th percentile and a HD>2 standard deviations, increased the odds of PED by a factor of 5.12 (P<0.001) and 1.39 (P<0.005), respectively.

Conclusion: HV is a significant predictor of a PED. Our higher rate of previous measurement availability is likely due to our effective referral screening protocol. The availability of these measurements, which are essential for HV calculation, are likely to reduce delays in diagnosis and management.

Keywords: Growth charts; Paediatric endocrine diagnosis; Short stature referrals.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Flow chart for short stature referrals.
Figure 2.
Figure 2.
Distribution of pediatric endocrine diagnoses.
See this image and copyright information in PMC

References

    1. Marchand V. Promoting Optimal Monitoring of Child Growth in Canada: Using the New World Health Organization Growth Charts. A Collaborative Statement of Dietitians of Canada, Canadian Paediatric Society, The College of Family Physicians of Canada, and Community Health Nurses of Canada. Canadian Journal of Dietetic Practice and Research - Vol 71 No 1, Spring 2010. - PubMed
    1. Rosenfeld RG, Albertsson-Wikland K, Cassorla F, et al. . Diagnostic controversy: The diagnosis of childhood growth hormone deficiency revisited. J Clin Endocrinol Metab 1995;80(5):1532–40. - PubMed
    1. Cohen P, Rogol AD, Deal CL, et al. ; 2007 ISS Consensus Workshop participants. Consensus statement on the diagnosis and treatment of children with idiopathic short stature: A summary of the growth hormone research society, the Lawson Wilkins Pediatric Endocrine Society, and the European Society for Paediatric Endocrinology Workshop. J Clin Endocrinol Metab 2008;93(11):4210–7. - PubMed
    1. Nwosu BU, Lee MM. Evaluation of short and tall stature in children. Am Fam Physician 2008;78(5):597–604. - PubMed
    1. Ahmed ML, Allen AD, Sharma A, Macfarlane JA, Dunger DB. Evaluation of a district growth screening programme: The Oxford growth study. Arch Dis Child 1993;69(3):361–5. - PMC - PubMed