Sekhon Sarpreet S, Crick Katelynn, Myroniuk Tyler W, Hamming Kevin S C, Ghosh Mahua, Campbell-Scherer Denise, Yeung Roseanne O
Core Internal Medicine Program, Faculty of Medicine and Dentistry, University of Alberta, AB, Canada.
Office of Lifelong Learning & the Physician Learning Program, Faculty of Medicine and Dentistry, University of Alberta, AB, Canada.
J Endocr Soc. 2021 Dec 9;6(4):bvab184. doi: 10.1210/jendso/bvab184. eCollection 2022 Apr 1.
Adrenal insufficiency (AI) is an uncommon, life-threatening disorder requiring lifelong treatment with steroid therapy and special attention to prevent adrenal crisis. Little is known about the prevalence of AI in Canada or healthcare utilization rates by these patients.
We aimed to assess the prevalence and healthcare burden of AI in Alberta, Canada.
This study used a population-based, retrospective administrative health data approach to identify patients with a diagnosis of AI over a 5-year period and evaluated emergency and outpatient healthcare utilization rates, steroid dispense records, and visit reasons.
The period prevalence of AI was 839 per million adults. Patients made an average of 2.3 and 17.8 visits per year in the emergency department and outpatient settings, respectively. This was 3 to 4 times as frequent as the average Albertan, and only 5% were coded as visits for AI. The majority of patients were dispensed glucocorticoid medications only.
The prevalence of AI in Alberta is higher than published data in other locations. The frequency of visits suggests a significant healthcare burden and emphasizes the need for a strong understanding of this condition across all clinical settings. Our most concerning finding is that 94.3% of visits were not labeled with AI, even though many of the top presenting complaints were consistent with adrenal crisis. Several data limitations were discovered that suggest improvements in the standardization of data submission and coding can expand the yield of future studies using this method.
肾上腺功能不全（AI）是一种罕见的、危及生命的疾病，需要终身接受类固醇治疗，并特别注意预防肾上腺危象。关于加拿大AI的患病率或这些患者的医疗利用率，人们知之甚少。
我们旨在评估加拿大艾伯塔省AI的患病率和医疗负担。
本研究采用基于人群的回顾性行政健康数据方法，确定在5年期间被诊断为AI的患者，并评估急诊和门诊医疗利用率、类固醇配药记录及就诊原因。
AI的期间患病率为每百万成年人839例。患者每年在急诊科和门诊的就诊次数分别平均为2.3次和17.8次。这是艾伯塔省普通居民的3至4倍，且只有5%的就诊被编码为因AI就诊。大多数患者仅被配给糖皮质激素药物。
艾伯塔省AI的患病率高于其他地区公布的数据。就诊频率表明存在重大的医疗负担，并强调在所有临床环境中都需要深入了解这种疾病。我们最令人担忧的发现是，尽管许多最常见的主诉与肾上腺危象一致，但94.3%的就诊未被标记为AI。发现了几个数据局限性，表明数据提交和编码标准化方面的改进可以提高未来使用这种方法的研究的产出。
