title: Assessment of Sex Differences for Treatment, Procedures, Complications, and Associated Conditions Among Adolescents Hospitalized with Crohn's Disease.
abstract: BACKGROUND
  Sex differences among adults in healthcare treatment and outcomes have been reported; however, there is a paucity of literature regarding pediatric populations, particularly adolescents with Crohn's disease (CD). The objective was to identify whether sex differences exist with respect to complications, procedures, and medication usage (corticosteroids, biological agents, and total parenteral nutrition) among hospitalized adolescents with CD.
  
  
  METHODS
  Adolescents with CD (n = 5782) hospitalized between April 1, 2004, and June 30, 2012, were selected from the Pediatric Health Information System database with a 1:1 ratio of males to females by hospital. Frequency of disease complications, associated conditions, procedures performed, and medication usage were analyzed with nonparametric statistical tests for the existence of sex differences.
  
  
  RESULTS
  Five thousand seven hundred eighty-two patients were included with a median age of 15 years. Females were slightly more likely to have anemia (29% versus 25%, P = 0.012), infection (12% versus 8%, P = 0.001), and mood disorder (9% versus 6%, P < 0.001), whereas males had more maturational delays (3% versus 1%, P = 0.004) and malnutrition (18% versus 14%, P = 0.027). Among procedures, only one category demonstrated a sex difference: females had more blood product transfusions (9% versus 6%, P < 0.001). Female rates for corticosteroids (62%), biological agents (16%), and total parenteral nutritionTPN (18%) were not statistically different from those for males (62%, 15%, and 20%, respectively). There were no differences in length of stay by sex.
  
  
  CONCLUSIONS
  This cross-sectional study of an administrative database identified few sex differences among adolescents with CD. The effect sizes were universally small and generally consistent with known sex differences unrelated to IBD.
authors.affiliation: *Division of Pediatric Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, Ohio; †The Center for Innovation in Pediatric Practice, The Research Institute, Nationwide Children's Hospital, Columbus, Ohio; and ‡Division of Gastroenterology and Hepatology, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Dotson
authors.forename: Josh B
authors.initials: JB
authors.lastname: Bricker
authors.forename: Michael D
authors.initials: MD
authors.lastname: Kappelman
authors.forename: Deena
authors.initials: D
authors.lastname: Chisolm
authors.forename: Wallace V
authors.initials: WV
authors.lastname: Crandall
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000740:Anemia / Q000453:epidemiology; D015331:Cohort Studies; D003424:Crohn Disease / Q000150:complications* / Q000628:therapy*; D003430:Cross-Sectional Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D007239:Infections / Q000453:epidemiology; D008297:Male; D044342:Malnutrition / Q000453:epidemiology; D019964:Mood Disorders / Q000453:epidemiology; D012737:Sex Factors; D012741:Sexual Maturation; D014481:United States
chemical_list: D000305:Adrenal Cortex Hormones