Background and Aim:
The composition of non-diabetes endocrine admissions and referrals for consultation to the Endocrine Service is not well understood and we aimed to characterize these occasions of service at a metropolitan hospital.
Methods:
Consecutive endocrinology admissions and consultation data were collected by two Endocrine Advanced Trainees between February 2020 and January 2021. Standard demographic data, primary +/- secondary endocrine issue and referring team details were collected for all encounters. Diabetes as a primary referral issue was excluded.
Results:
428 of 1454 total encounters were related to non-diabetes endocrine issues (29.4%), with 83.9% (n=359) consultation referrals and 16.1% (n=69) admissions under our service. 63.3% (n=271) were female (61.9±19.8 years) and 36.7% (n=157) were male (61.6±17.3 years). The respiratory (n=57), cardiology (n=56) and geriatrics (n=53) teams provided the most number of non-diabetes endocrine referrals and represent 38.5%, 28.3% and 34.4% of their total endocrine consult load respectively. Electrolyte disorders formed the majority of encounters, comprised of sodium (n=99), calcium (n=75) and potassium disorders (n=8). Thyroid referrals were next common, including thyroid function disorders (n=98), thyroid mass (n=16), pregnancy thyroid disorders (n=9) and thyroid cancer (n=2). The remaining referral categories include adrenal disorders (n=42), pituitary disorders (n=18), other (n=14), osteoporosis/ bone disorders (n=12), non-diabetic hypoglycaemia (n=10), obesity (n=10), lipid disorders (n=7), hypertension (n=5), neuroendocrine tumour (n=2) and gonadal disorders (n=1). 18 patients had diabetes as a secondary referral issue. Geriatrics provided 21/75 of calcium disorders whereas cardiology provided 28/121 of thyroid disorders, reflective of the underlying pathologies seen in these specialties. The most common admission diagnosis was sodium disorders, specifically hyponatraemia (36/69 admissions), adrenal insufficiency (7/69) and other (7/69).
Conclusion:
Endocrinology is a busy clinical service in our hospital and a significant proportion of the workload is non-diabetes endocrinology. Service audits provide meaningful information on the distribution and patterns of referrals.