School of Medicine Sydney, The University of Notre Dame, Australia, Sydney, New South Wales, Australia.
Endocrine and Metabolic Unit, Royal Adelaide Hospital and University of Adelaide, Adelaide, South Australia, Australia.
Clin Endocrinol (Oxf). 2019 Jul;91(1):41-47. doi: 10.1111/cen.13985. Epub 2019 Apr 29.
Hydrocortisone stress dosing during illness can prevent adrenal crises (AC) in patients with adrenal insufficiency (AI). When patients cannot communicate, medical identification jewellery may facilitate parenteral hydrocortisone provision but patient adoption rates are not known.
A cross-sectional analysis of Australian medical identification jewellery subscription data.
Patients with AI aged 20 years and over with an active subscription to a large medical jewellery provider.
Subscription rates by AI subtype, geographic area, age and gender.
There were 1955 patients with AI and an active subscription in the database, corresponding to a subscription rate of 105.79/million or approximately one-third of the AI population. The subscription rate was substantially higher in primary AI (60.72/million) than secondary AI (23.16/million), corresponding to approximately 60.7% and 11.6% of the estimated population prevalence of each disorder, respectively. There was substantial variation in use by state/territory, with the highest subscribing state having a rate of over four times that of the lowest (P < 0.001). Women comprised 64.8% (n = 1266) of the group. Subscription also varied by age, being highest in the 60-69 year age group (165.15/million) and lowest in those aged 30-39 years (47.23/million) (P < 0.001). Few patients (4.8%, n = 94) mentioned, either in their record or on their jewellery, the need for urgent parenteral hydrocortisone in the event of severe illness.
Medical jewellery is a component of AC risk reduction. However, subscription appears to be underutilised in the Australian AI population, especially among patients with secondary AI. Urgent treatment recommendations should be inscribed on the jewellery.
在患病期间给予氢化可的松应激剂量可以预防肾上腺危象（AC）在肾上腺功能不全（AI）患者中。当患者无法沟通时，医疗识别珠宝可能有助于提供静脉氢化可的松，但患者的采用率尚不清楚。
对澳大利亚医疗识别珠宝订阅数据的横断面分析。
年龄在 20 岁及以上且对大型医疗珠宝提供商有活跃订阅的 AI 患者。
按 AI 亚型、地理区域、年龄和性别划分的订阅率。
数据库中有 1955 名 AI 患者有活跃订阅，对应的订阅率为 105.79/百万，约为 AI 人群的三分之一。原发性 AI（60.72/百万）的订阅率明显高于继发性 AI（23.16/百万），分别对应于这两种疾病估计人群患病率的 60.7%和 11.6%左右。各州/领地的使用情况存在很大差异，订阅率最高的州是最低的州的四倍多（P<0.001）。该组中女性占 64.8%（n=1266）。订阅还随年龄而变化，60-69 岁年龄组最高（165.15/百万），30-39 岁年龄组最低（47.23/百万）（P<0.001）。很少有患者（4.8%，n=94）在他们的记录或珠宝上提到，在重病情况下需要紧急静脉给予氢化可的松。
医疗珠宝是降低 AC 风险的组成部分。然而，在澳大利亚 AI 人群中，这种订阅似乎没有得到充分利用，尤其是在继发性 AI 患者中。应在珠宝上刻上紧急治疗建议。
