Work

Adrenal Crisis and Adrenal Insufficiency Admissions in Patients 30–59 Years: Contribution of Psychosocial Factors

Year: 2024

Type: article

Abstract: BACKGROUND AND OBJECTIVE: Adrenal crises (AC) occur in middle aged adults with adrenal insufficiency (AI). Psychosocial difficulties may impede effective self-management in some cases. This study aimed to investigate associations between psychosocial problems and hospital admissions for AI/AC in middle aged adults. DESIGN AND PATIENTS: Data on all hospitalisations among patients aged 30-59 years with a diagnosis of AI were extracted from a regional database for the years 2005-2020. MEASUREMENTS: Trends in hospitalisations and associations between admissions and comorbid psychosocial problems were assessed. RESULTS: Of the 3948 admissions for AI between 2005 and 2020, 63.4% were in women. Admissions increased by 91.4%, from 61.89 to 118.44/million (p < 0.0001), while AC admission rates increased by 176.5% (from 7.71 to 21.33/million, p=NS). Secondary AI (SAI) admissions rose by 133.0%, from 27.98/million to 65.20/million (p < 0.001). Admissions increased in women in each decade but only in males aged 50-59 years. Comorbid infection was identified in 28.1% of admissions and at least one comorbid contributory psychological problem was found in 25.6%. Males, patients with SAI and those not living in a domestic partnership had a higher combined psychosocial problem burden. Females admitted with at least one sign of an AC had significantly higher psychosocial problem scores than those with less severe presentations. CONCLUSIONS: These results suggest that psychosocial factors may play a role in some admissions for AI/AC in adults aged between 30 and 59 years, possibly contributing to the otherwise unexplained rise in hospitalisations for AI.

Source: Clinical Endocrinology

DOI: 10.1111/cen.15166

Authors: R. Louise Rushworth, Henrik Falhammar, David J. Torpy

Institutions: The University of Notre Dame Australia, Karolinska University Hospital, Karolinska Institutet, Royal Adelaide Hospital, The University of Adelaide

Language: English

Topic: Adrenal Hormones and Disorders

Subfield: Endocrinology, Diabetes and Metabolism

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: bronze

Funder: NSW Ministry of Health