Table 2.
Clinical characteristics of patients with adrenal crisis at admission separated by different pathophysiological mechanisms
| Primary AI | Central AI | Others | ALL | ||
|---|---|---|---|---|---|
| (N = 23) | (N = 136) | (N = 345) | (n = 504) | ||
| Age (years) | Median (IQR) | 59 (36–73) | 65 (49–74) | 73 (62–82) | 71 (59–80) |
| Male | 9 (39.1) | 73 (53.7) | 173 (50.1) | 255 (50.6) | |
| Indication for hospital admissiona | Adrenal insufficiencyb | 6 (26.1) | 26 (19.1) | 50 (14.5) | 82 (16.3) |
| Pituitary disease | 3 (13.0) | 69 (50.7) | 2 (0.6) | 74 (14.7) | |
| Cancer | 3 (13.0) | 2 (1.5) | 69 (20.0) | 74 (14.7) | |
| Infection | 2 (8.7) | 10 (7.4) | 44 (12.8) | 56 (11.1) | |
| Cardiovascular disease | 0 (0.0) | 2 (1.5) | 19 (5.5) | 21 (4.2) | |
| Sepsis | 1 (4.3) | 3 (2.2) | 13 (3.8) | 17 (3.4) | |
| Adrenal tumor | 0 (0.0) | 0 (0.0) | 10 (2.9) | 10 (2.0) | |
| AI-related clinical symptomc | 2 (8.7) | 12 (8.8) | 44 (12.8) | 58 (11.5) | |
| Comorbidityd | Cardiovascular disease | 7 (30.4) | 40 (29.4) | 109 (31.6) | 156 (31.0) |
| Infection | 5 (21.7) | 26 (19.1) | 65 (18.8) | 96 (19.0) | |
| Diabetes | 1 (4.3) | 22 (16.2) | 57 (16.5) | 80 (15.9) | |
| Cancer | 1 (4.3) | 0 (0.0) | 66 (19.1) | 67 (13.3) | |
| Hypothyroidism | 2 (8.7) | 27 (19.9) | 24 (7.0) | 53 (10.5) | |
| Autoimmune disease | 0 (0.0) | 1 (0.7) | 32 (9.3) | 33 (6.5) | |
| Peptic ulcer | 2 (8.7) | 9 (6.6) | 21 (6.1) | 32 (6.3) | |
| COPD or asthma | 1 (4.3) | 4 (2.9) | 21 (6.1) | 26 (5.2) | |
| Renal failure | 0 (0.0) | 5 (3.7) | 21 (6.1) | 26 (5.2) | |
| Therapeutic GC regimen | HC | 18 (78.3) | 107 (78.7) | 203 (58.8) | 328 (65.3) |
| mPSL | 4 (17.4) | 14 (10.3) | 56 (16.2) | 74 (14.7) | |
| DEX | 1 (4.3) | 6 (4.4) | 37 (10.7) | 44 (8.7) | |
| Others | 0 (0.0) | 9 (6.6) | 49 (14.2) | 58 (11.3) |
Abbreviations: AI adrenal insufficiency, IQR interquatile, COPD chronic obstructive pulmonary disease, GC glucocorticoid, HC hydrocortisone, mPSL methylprednisolone, DEX dexamethasone
aIdentified as disease or symptom requiring admission decision, registered according to the Japanese diagnostic procedure combination (DPC) system
bConsidering the following admission and therapeutic GC administration, this group is consistent with hospitalization due to adrenal crisis
cConsisted of unspecified coma, hyponatremia, unspecified hypotension, volume depletion, shock, anorexia, nausea, vomiting, unspecified fever and hypoglycemia
dIdentification of comorbidity is based on comorbidity lists at admission, registered according to the Japanese diagnostic procedure combination (DPC) system