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Exploring Inpatient Hospitalizations and Morbidity in Patients With Adrenal Insufficiency.

Artikel i vetenskaplig tidskrift
Författare Paul M Stewart
Beverly M K Biller
Claudio Marelli
Candace Gunnarsson
Michael P Ryan
Gudmundur Johannsson
Publicerad i The Journal of clinical endocrinology and metabolism
Volym 101
Nummer/häfte 12
Sidor 4843-4850
ISSN 1945-7197
Publiceringsår 2016
Publicerad vid Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition
Sidor 4843-4850
Språk en
Länkar dx.doi.org/10.1210/jc.2016-2221
www.ncbi.nlm.nih.gov/entrez/query.f...
Ämnesord Adrenal insufficiency, hypopituitarism, congenital adrenal hyperplasia, Addison's disease
Ämneskategorier Endokrinologi

Sammanfattning

Patients with adrenal insufficiency (AI) (primary AI [PAI], secondary AI due to a pituitary disorder [PIT] and congenital adrenal hyperplasia [CAH]) have reduced life expectancy; however, the underlying explanation remains unknown.To evaluate characteristics, comorbidities, and hospitalizations in AI patients.Retrospective observational.Using a United States-based national payer database comprising of more than 108 million members, strict inclusion criteria including diagnostic codes and steroid prescription records were used to identify 10 383 adults with AI; 1014 with PAI, 8818 with PIT, and 551 with CAH. Patients were matched 1:1 to controls, based on age (±5 y), gender, insurance, and region and followed for more than 12 months.None.Demographic variables, comorbidities (diabetes mellitus [DM] types 1 and 2, depression, anxiety, hyperlipidemia, hypertension) and hospitalization incidence.Compared with controls, patients with AI had higher odds of DM, hypertension, hyperlipidaemia, depression, and anxiety, ranging from an odds ratio (OR) of 1.51 for hyperlipidaemia in PAI to 3.85 for DM in CAH. Odds of having DM (OR, 3.85; 95% confidence interval, 2.52-5.90) or anxiety (OR, 2.99; 95% confidence interval, 2.02-4.42) compared with controls were highest in CAH, whereas depression was highest in PAI and PIT (OR, 2.40 and 2.55). ORs of hyperlipidaemia and hypertension (OR, 1.98 and 2.24) were highest in the PIT cohort. Inpatient admissions were more frequent in PAI (4.64:1; P < .0001) and PIT (4.00:1; P < .0001) than controls; infection was the most common cause for admission.Patients with AI carry a significant metabolic and psychiatric burden, with higher risk of comorbidities and hospital admissions than matched controls.

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