ArticleWorld journal of emergency medicine2025
Clinical characteristics of acute adrenal insufficiency in emergency patients: an analysis of data in Lhasa, Xizang Autonomous Region of China.
Article in World journal of emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe nonspecific clinical presentation of adrenal insufficiency (AI) frequently leads to misdiagnosis, often as psychiatric or gastrointestinal disorders. AI is classified anatomically as primary AI (PAI), secondary AI (SAI), or tertiary AI (TAI). Without timely recognition, progression to adrenal crisis (AC) can result in life-threatening outcomes. This study aimed to systematically analyze the clinical features, etiologies, and outcomes of AI in Lhasa's emergency population to improve diagnostic accuracy and optimize clinical management.
methodsA retrospective analysis of emergency department admissions from January 2020 to August 2024 at People's Hospital of Xizang Autonomous Region was conducted. AI diagnoses were identified via International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes from electronic health records (EHR). Patients were grouped into incipient AC (IAC) or AC cohorts based on hemodynamic status. Demographic profiles, etiologies, clinical presentations, and laboratory results were analyzed.
resultsForty-three AI patients were identified. The population-standardized admission rate for AI increased from 9 to 16 per million person-years, with PAI cases doubling during this period. Adrenal tuberculosis (58.1%) and adrenal hematoma (18.6%) were the leading etiologies. Compared to the IAC group, the AC group demonstrated lower systolic blood pressure (SBP) (
conclusionAI incidence is rising in high-altitude regions, with adrenal tuberculosis remaining the most common cause. AC is associated with increased inflammatory responses, hemodynamic instability, and metabolic disturbances. Targeted interventions are required to improve outcomes.
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