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首页> 外文期刊>Endocrinology, Diabetes & Metabolism >Interaction between hypotension and age on adrenal crisis diagnosis
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Interaction between hypotension and age on adrenal crisis diagnosis

机译：肾上腺危机诊断的低血压与年龄的相互作用

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Objective To determine whether adrenal crisis (AC) identification may be affected by the definition of hypotension. Context Delays in AC diagnosis can result in adverse outcomes. AC‐related cardiovascular compromise may vary according to baseline blood pressure and may be associated with delayed AC detection in some patients. Design A retrospective study of paired systolic blood pressure (sBP) measurements in hospitalized patients with primary AI (PAI). Patients Patients with PAI and an acute illness admitted for urgent treatment between 2000 and 2017. Measurements A comparison between sBP on hospital arrival and on discharge. Hypotension was classified as either absolute hypotension (sBP 100mg or lower) or relative hypotension (sBP over 100?mg but at least 20?mm?Hg lower than discharge sBP). Results Of 152 admissions with paired blood pressure measurements, 46 (30.3%) included a medically diagnosed AC. Absolute hypotension was found in 38 (25.0%) records, and a further 21 (13.8%) patients were classified as having relative hypotension. Patients aged 65?years and older had the lowest (14.8%, n?=?8) proportion with absolute hypotension but the highest (27.8%, n?=?15) with relative hypotension. Use of either absolute or relative hypotension as the criterion for AC diagnosis increased the proportion of patients with an AC by 28.3% and the proportion of patients with an AC in the oldest age group by 130%. Conclusions Failure to detect cardiovascular compromise is common in older AI patients, may underestimate the AC rate in this group, and delay essential treatment. Relative hypotension may play a role in AC diagnosis.
机译：目的判断肾上腺危机（AC）鉴定是否可能受到低血压定义的影响。 ac诊断的上下文延迟可能导致不利的结果。与基线血压有关的相关心血管折衷可能会根据基线血压而变化，并且某些患者中可能与延迟的AC检测相关。设计初级AI（PAI）住院患者配对收缩压（SBP）测量的回顾性研究。患者PAI患者和急性疾病的急性疾病在2000年至2017年期间接受迫切治疗。测量SBP在医院到达和出院时的比较。低血压被分类为绝对的低血压（SBP 100mg或更低）或相对的低血压（SBP超过100μmg但至少20μmΩ·汞而低于放电SBP）。成对血压测量的结果152例，46（30.3％）包括医学诊断的AC。在38（25.0％）记录中发现了绝对的低血压，另外21例（13.8％）患者被归类为具有相对的低血压。 65岁的患者具有最低（14.8％，n？=Δ8），其具有绝对的低血压，但具有相对低血压的最高（27.8％，N？= 15）。使用绝对或相对的低血压作为交流诊断的标准增加了AC患者的比例28.3％，并且在最年龄组中AC的患者比例为130％。结论未捕获较旧的AI患者常见的心血管妥协常见，可能低估了该组的AC率，以及延迟必要的治疗。相对的低血压可能在AC诊断中发挥作用。

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