Introduction: To determine the magnitude of gender difference in paediatric hospital admissions.Materials and Methods: We reviewed discharge data of general medical paediatric admissions to a university teaching hospital in Hong Kong from 1984 to 2000. Based on ICD-9 codes, 9 broad categories of disease with related sub-categories were used, namely respiratory, gastrointestinal, neurological, renal, cardiac, haematological/oncological, neonatal, miscellaneous and social. Data on patients admitted to the haematological, oncological and neonatal wards were excluded from this analysis. Results: There were 92,332 patients admitted to the general paediatric wards. The 7 leading causes for admission accounted for 62% of all admissions: gastroenteritis (14%), upper respiratory tract infections (12%), asthma/wheezy bronchitis (10%), pneumonia (10%), bronchiolitis (6%), febrile convulsions (7%) and other convulsions (4%). Across almost all categories, there was a consistent excess of males (59.1% of all admissions). The male excess was even more pronounced for urinary tract infections (72%) and nephrotic syndrome (80%). The main sub-categories without this male predominance were accidents, accidental ingestion and social admissions (50% males), failure to thrive (49% males), acyanotic congenital heart disease (48%), endocrine (42%), auto-immune conditions (30%) and attempted suicide (19%). Conclusions: Although male vulnerability to illness has long been recognised, the consistency and magnitude of these gender differentials in admissions was impressive. More vigorous exploration of the underlying mechanisms responsible for this phenomenon is warranted.
Gender difference in the incidence of childhood diseases has long been recognised. but the magnitude of this effect and consistency across many disease categories appears not to attract much attention or research interest. Gissler and colleagues, in a longitudinal follow-up of all children born in Finland in 1987, reported that boys had a 20% higher risk for a low 5-min Apgar score and 11% higher risk for being born preterm.
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