Incidence and Risk Factors for Adrenal Crisis in Pediatric-onset Adrenal Insufficiency: A Prospective Study
Authors' conclusion
A substantial proportion of patients with pediatric-onset AI experience AC. Younger age and an increased number of infections are independent risk factors for developing AC in these patients.
Study context
- Population
- Patients diagnosed with adrenal insufficiency (AI) at age ≤15 years, Japan; 213 (61%) primary AI, 136 (39%) secondary AI; median age at enrollment 14.3 years (IQR 8.5–21.2 years)961 person-year (PY) follow-up
- Participants
- 349 patients
- Outcome
- Incidence of AC (events per person-year) and risk factors for AC (Poisson regression multivariable analysis)
- Follow-up
- Median 2.8 years (IQR 2.2-3.3 years)
Methodological detailsmulticenter
- Multicenter
Main finding
As reported in the abstract
Incidence of AC
- Adrenal crisis (AC) events (in 31 patients)
- 41
- Incidence of AC per 100 PY
- 4.27 (95% CI, 3.15-5.75)
- Younger age at enrollment: RR
- 0.93 (95% CI, 0.89-0.97)
- Increased number of infections: RR
- 1.17 (95% CI, 1.07-1.27)
- Female sex: RR, not significant
- 0.99 (95% CI, 0.53-1.86)
- Primary AI: RR, not significant
- 0.65 (95% CI, 0.30-1.41)
- Hydrocortisone-equivalent dose per m² body area: RR, not significant
- 1.02 (95% CI, 0.96-1.08)
Observational data: associations, not effects.
Original publication
Incidence and Risk Factors for Adrenal Crisis in Pediatric-onset Adrenal Insufficiency: A Prospective Study. J Clin Endocrinol Metab. Published 21 December 2023. doi:10.
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