ECE2019 Poster Presentations Pituitary and Neuroendocrinology 2 (70 abstracts)
Adrenal crisis in treated patients with Cushing’s syndrome
Leonie Broersen 1 , Femke van Haalen 1 , Tina Kienitz 2 , Olaf Dekkers 1 , Christian Strasburger 2 , Alberto Pereira 1 & Nienke Biermasz 1
1Leiden Univeristy Medical Center, Leiden, Netherlands; 2Charité-Universitätsmedizin Berlin and Berlin Institute of Health, Berlin, Germany.
Background: Adrenal crisis, the most feared complication of adrenal insufficiency, is a potentially life-threatening situation of acute glucocorticoid deficiency. After successful surgery, many patients with Cushing’s syndrome develop (transient) adrenal insufficiency. The incidence of adrenal crisis in patients treated for hypercortisolism is unknown.
Methods: Cohort study including consecutive patients with Cushing’s syndrome with adrenal insufficiency after surgery from Leiden and Berlin from 2000–2015. We summarized incidence of adrenal crisis, compared patients with and without adrenal crisis regarding potential risk factors for its occurrence, and assessed the effect of better education in time on incidence of adrenal crisis.
Results: We included 106 patients, of whom 19 had in total 41 adrenal crises. There were 9.0 crises per 100 patient-years at risk (95% confidence interval [CI]: 6.7–12.0). All crises occurred while on hydrocortisone substitution. The risk ratio for a recurrent crisis was 2.3 (95% CI: 1.2–4.6). No clear change in incidence of adrenal crisis due to better education in time was observed. There was no difference in recurrence rate between patients with and without any crisis, but patients with adrenal crisis had more complications (anterior pituitary deficiency and diabetes insipidus).
Conclusions: Previous adrenal crisis is a risk factor for recurrent crisis. However, further risk factor analysis is needed. Effective education methods to prevent adrenal crises should be identified, including nursing staff education for prevention of adrenal crises during hospital stay immediately after surgery.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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