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The following is a summary of “Clinical characteristics of adrenal crisis in 371 adult patients with glucocorticoid-induced adrenal insufficiency,” published in the December 2024 issue of Endocrinology by Qiu et al.   

Glucocorticoid-induced adrenal insufficiency (GIAI) is a condition caused by long-term use of exogenous steroids, leading to dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis. Adrenal crisis (AC) is a severe and potentially life-threatening complication of GIAI.  

Researchers conducted a retrospective study to analyze AC’s clinical characteristics and risk factors in people with GIAI.  

They included clinical data from adult people with GIAI treated at the hospital (January 1, 2014, and December 31, 2023). Information on demographics, clinical features, lab results, and comorbidities was collected. Univariate and multivariate regression analyses were used to identify risk factors for AC. Machine learning models were developed for prediction.  

The results showed that 51 people (13.75%) developed AC; mortality was significantly higher in people with AC compared to those without. Multivariate logistic regression identified infection, psychiatric symptoms, serum sodium, albumin, neutrophil-lymphocyte ratio (NLR), and eosinophil-lymphocyte ratio (ELR) as independent risk factors for AC. The logistic regression model demonstrated the best prediction accuracy for AC in these people.  

They concluded that NLR and ELR, along with other clinical indicators, may effectively predict AC in people with GIAI. The logistic regression model showed the best predictive performance.  

Source: frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2024.1510433/full