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Table 4 Clinical characteristics at admission of narrowly defined cases of AC and non-narrowly defined cases of AC

From: Clinical characteristics of adrenal crisis in adult population with and without predisposing chronic adrenal insufficiency: a retrospective cohort study

   Narrowly defined case Non-narrowly defined case
   (n = 201) (n = 303)
Age(years) Median [IQR] 72 (60–81) 70 (57–79.5)
<40 yr 18 (9.0) 29 (9.6)
40 yr. <60 yr 31 (15.4) 57 (18.8)
60 yr. <80 yr 95 (47.3) 141 (46.5)
80 yr 57 (28.4) 76 (25.1)
Male   102 (50.7) 153 (50.5)
Predisposing disease Primary AI 7 (3.5) 16 (5.3)
Central AI 75 (37.3) 61 (20.1)
Others 119 (59.2) 226 (74.6)
Indication for hospital admissiona Adrenal insufficiencyb 52 (25.9) 30 (9.9)
Pituitary disease 41 (20.4) 33 (10.9)
Cancer 7 (3.5) 67 (22.1)
Infection 15 (7.5) 41 (13.5)
Cardiovascular disease 7 (3.5) 14 (4.6)
Sepsis 6 (3.0) 11 (3.6)
Adrenal tumor 4 (2.0) 6 (2.0)
AI-related clinical symptomc 40 (19.9) 18 (5.9)
Therapeutic GC regimen HC 149 (74.1) 179 (59.1)
mPSL 24 (11.9) 50 (16.5)
DEX 15 (7.5) 29 (9.6)
Others 13 (6.5) 45 (14.9)
Hormone testing ACTH 178 (88.6) 56 (18.5)
Cortisol 194 (96.5) 64 (21.1)
Endocrine stimulation testd 27 (13.4) 13 (4.3)
Adrenal cortex stimulation test 15 (7.5) 6 (2.0)
Visited before admission Yes, within 90 days before 124 (61.7) 213 (70.3)
Yes, within 14 days before 90 (44.8) 151 (49.8)
Under GC-related medication Oral GC 33 (16.4) 71 (23.4)
HC equivalent daily dosage (mg) 20 (12–30) 20 (20–40)
Median [IQR]   
Intranasal GC 0 (0.0) 0 (0.0)
Inhaled GC 8 (4.0) 7 (2.3)
Drug interacting with GC 4 (2.0) 9 (3.0)
  1. Abbreviations: AI adrenal insufficiency, GC glucocorticoid, HC hydrocortisone, mPSL methylprednisolone, DEX dexamethasone, ACTH adrenocorticotropic hormone, IQR Interquartile.
  2. aIdentified as disease or symptom requiring decision to admit registered in the DPC system
  3. bConsidering the following admission and therapeutic GC administration, this group is consistent with hospitalization due to adrenal crisis
  4. cConsisted of unspecified coma, hyponatremia, unspecified hypotension, volume depletion, shock, anorexia, nausea, vomiting, unspecified fever and hypoglycemia
  5. dEndocrine stimulation test consists of hormone dynamic testing of the following: anterior pituitary (growth hormone, gonadotropin, thyroid stimulating hormone, prolactin, adrenocorticotropic hormone), posterior pituitary (antidiuretic hormone), thyroid, parathyroid, and gonad (testosterone, estradiol). Endocrine tests of adrenocorticotropic hormone included insulin tolerance test, metyrapone test, dexamethasone suppression test, and corticotropin-releasing hormone stimulation test. In this study, we counted results of the adrenal cortex stimulation test apart from those for endocrine stimulation tests. The adrenal stimulation tests evaluates adrenal cortex function, which is related to glucocorticoid or mineralocorticoid, for example, the adrenocorticotropic hormone stimulation test