Medical Journal of the Islamic Republic Of Iran
مجله پزشکی جمهوری اسلامی ایران
Med J Islam Repub Iran
Medical Sciences
http://mjiri.iums.ac.ir
2
journal2
1016-1430
2251-6840
8
10.18869/mjiri
14
8888
13
en
jalali
1399
10
1
gregorian
2021
1
1
35
1
online
1
fulltext
en
Adrenal Insufficiency in Septic Patients Admitted to Intensive Care Unit: Prevalence and Associated Factors
Endocrinology
Endocrinology
Original Research
Original Research
<strong>Background: </strong>Adrenal insufficiency (AI) is associated with an increase in the risk of mortality in ICU-admitted septic patients. It should be suspected not only in patients with septic shock but also in those with sepsis. The aim of this study was to investigate the prevalence of AI in the spectrum of septic patients and determine the main predictors of this condition.<br>
<strong>Methods:</strong> This study included 99 patients with the diagnosis of sepsis, severe sepsis, or septic shock. Patients with basal cortisol < 10 μg/dl or those with ∆ cortisol < 9 μg/dl after the cosyntropin test were considered as having AI. Appropriate statistical tests were used for comparing the variables between the two groups. A logistic regression model was applied to determine the predictors of AI. The P-value <0.05 was considered as a significant level.<br>
<strong>Results:</strong> AI was found in 25 (25.3%) of these patients. There was no significant difference in the occurrence of AI in patients with sepsis, severe sepsis, or septic shock. Patients with positive blood culture (OR (95% CI); 7.8 (3.5-9.1); p=0.021) or those with CRP≥ 3+ (OR (95% CI); 14.1 8 (5.7-16.2); p<0.001) were more likely to develop AI.<br>
<strong>Conclusion:</strong> AI is prevalent among ICU admitted septic patients even in the absence of septic shock. The main predictors of AI are high levels of CRP and positive blood culture.
Adrenal Insufficiency, Sepsis, Septic Shock, C-Reactive Protein (CRP)
1149
1152
http://mjiri.iums.ac.ir/browse.php?a_code=A-10-6686-1&slc_lang=en&sid=1
Nahid
Hashemi-Madani
nahid.hashemimadani@gmail.com
200319475328460066154
200319475328460066154
No
Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
Marzieh
Miri
marziehmiri96@gmail.com
200319475328460066155
200319475328460066155
No
1. Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
Zahra
Emami
امامی
zemami64@gmail.com
200319475328460066156
200319475328460066156
No
1. Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
Mitra
Barati
Mitra_baraty@yahoo.com
200319475328460066157
200319475328460066157
No
Paediatric Infectious Diseases Research Centre, Iran University of Medical Science, Tehran, Iran
Fatemeh
Golgiri
golgiri.f@iums.ac.ir
200319475328460066158
200319475328460066158
Yes
Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran