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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