ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ MỘT SỐ YẾU TỐ LIÊN QUAN Ở BỆNH NHÂN SUY THƯỢNG THẬN DO GLUCOCORTICOIDS NHẬP VIỆN

Abstract

Objectives: To describe the clinical and subclinical characteristics of hospitalized patients with glucocorticoid-induced adrenal insufficiency at Bach Mai Hospital and to evaluate factors associated with adrenal insufficiency in this population. Methods: A cross-sectional descriptive study was conducted on 224 patients diagnosed with GC-induced adrenal insufficiency who were treated as inpatients at Bach Mai Hospital from January 2025 to the end of June 2025. Clinical and laboratory data were collected using a standardized medical record form. Data were analyzed using appropriate statistical tests and multivariable logistic regression. Results: The mean age was 63.67 ± 12.32 years; 61.6% of patients were ≥ 60 years old. Fatigue, Cushingoid appearance, and loss of appetite were the most common symptoms. Osteoporosis was common, with no significant difference between sexes. Fasting hyperglycemia was observed in 41.1% of patients and was significantly associated with the duration of GC use (OR = 1.071; p < 0.001). Conclusion: GC-induced adrenal insufficiency was common in patients over 60 years old. Clinical manifestations were nonspecific and easily overlooked. Osteoporosis and fasting hyperglycemia were common complications. Fasting hyperglycemia was associated with GC treatment duration, with a 7.1% increase in risk for each month of GC use. These findings emphasize the importance of screening and regular monitoring of blood glucose and bone density in patients receiving GCs. Dose reduction or early discontinuation of GCs should be considered to reduce complications.