Department of Family Medicine, Taipei Veterans General Hospital, Taiwan.
Tohoku J Exp Med. 2010 Aug;221(4):281-5. doi: 10.1620/tjem.221.281.
Adrenal insufficiency (AI), a life-threatening disorder, usually starts with variable nonspecific symptoms and signs of poor appetite, fatigue, fever, and gastrointestinal discomfort, and may progress to adrenal crisis with complications of electrolyte imbalance, change of consciousness or even shock. Epidemiological data about AI in the elderly population are limited. Based on nationwide hospitalization datasets in Taiwan, we retrospectively analyzed the annual incidence of AI among the elderly population (> or = 60 years old), as well as co-morbidities. The prevalence of AI increased from 6.5/10(5) (n = 1,293) in 1996 to 20.8/10(5) (n = 4,681) in 2007. In 2006, AI was newly diagnosed in 3,494 patients (1,701 women and 1,793 men), which represented an incidence of 15.5/10(5) in the whole population. Nearly four fifths (1,349 women and 1,429 men) of the patients were 60 years old and over, corresponding to an incidence of 92.4/10(5) in the elderly population. The most common co-morbidities were pneumonia (8.6%, n = 238) and urinary tract infections (6.9%, n = 193). Within the one-year observation after discharge, pneumonia was also the most frequent diagnosis in subsequent hospitalizations; besides, 178 (6.5%) patients died in the hospital and the common causes of death were respiratory failure (n = 34), septicemia (n = 23), pneumonia (n = 16), and chronic obstructive pulmonary disease (n = 9). In conclusion, the majority of the elderly have co-morbidities when AI was initially diagnosed. Infectious and pulmonary diseases as the most common co-morbidities also play a major role in subsequent hospitalizations and in-hospital deaths.
肾上腺功能不全（AI）是一种危及生命的疾病，通常以食欲不佳、疲劳、发热和胃肠道不适等多种非特异性症状和体征为起始症状，可能进展为伴有电解质失衡、意识改变甚至休克等并发症的肾上腺危象。有关老年人 AI 的流行病学数据有限。基于台湾全国住院数据集，我们回顾性分析了老年人群（≥60 岁）AI 的年发病率以及合并症。AI 的患病率从 1996 年的 6.5/10(5)（n = 1,293）上升至 2007 年的 20.8/10(5)（n = 4,681）。2006 年，新诊断出 3,494 例 AI 患者（女性 1,701 例，男性 1,793 例），占总人口的 15.5/10(5)。近五分之四（女性 1,349 例，男性 1,429 例）的患者年龄在 60 岁以上，占老年人口的 92.4/10(5)。最常见的合并症是肺炎（8.6%，n = 238）和尿路感染（6.9%，n = 193）。出院后一年内的观察发现，肺炎也是随后住院的最常见诊断；此外，178（6.5%）例患者在医院死亡，常见的死亡原因为呼吸衰竭（n = 34）、败血症（n = 23）、肺炎（n = 16）和慢性阻塞性肺疾病（n = 9）。总之，当 AI 首次诊断时，大多数老年人都有合并症。感染性和肺部疾病作为最常见的合并症，在随后的住院和院内死亡中也起着重要作用。
