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. 2024 Mar;28(1):20-26.
doi: 10.4235/agmr.23.0123. Epub 2023 Nov 21.

Prevalence of Adrenal Insufficiency in Korean Patients undergoing Total Knee Arthroplasty

So Won Baek  1 , Jung Ho Noh  2 , Yeon Sik Heo  3
Affiliations

Prevalence of Adrenal Insufficiency in Korean Patients undergoing Total Knee Arthroplasty

So Won Baek et al. Ann Geriatr Med Res. 2024 Mar.

Abstract

Background: This study investigated the prevalence of adrenal insufficiency among patients admitted for total knee arthroplasty (TKA) due to osteoarthritis and identified factors contributing to adrenal insufficiency.

Methods: We divided the patients into two groups based on the results of preoperative standard-dose short synchronous stimulation tests: group 1 (adrenal insufficiency) and group 2 (normal adrenal function). We also assessed the prevalence of adrenal insufficiency and compared the numbers of patients who received oral steroids, the frequency of previous steroid injection use, and the frequency of systemic symptoms of steroid depletion such as fatigue and loss of appetite between the two groups. Multiple regression analysis was performed to identify factors related to adrenal insufficiency.

Results: The prevalence of adrenal insufficiency was 60.0% (120/200). Group 1 had higher numbers of previous steroid injections (12.8±10.2 vs. 6.8±7.9) and patients taking oral steroids (18/120 vs. 3/80) (p<0.001 and p=0.011, respectively). The frequency of systemic symptoms of steroid depletion, such as fatigue and loss of appetite, was also higher in group 1 (94/120 vs. 42/80, p<0.001). Recent steroid injections and loss of appetite were associated with adrenal insufficiency (p=0.002 and p=0.009, respectively).

Conclusion: The results of this study revealed a high prevalence of adrenal insufficiency in Korean patients hospitalized for TKA due to end-stage osteoarthritis. Recent steroid injections were causally related to the development of adrenal insufficiency. Therefore, adrenal function should be assessed preoperatively to prevent postoperative complications related to adrenal insufficiency.

Keywords: Adrenal insufficiency; Arthroplasty; Knee; Prevalence; Replacement.

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Conflict of interest statement

CONFLICT OF INTEREST

The researchers claim no conflicts of interest.

Figures

Fig. 1.
Fig. 1.
Flow diagram of the subjects. TKA, total knee arthroplasty.
Fig. 2.
Fig. 2.
Flow diagram of the diagnosis of adrenal insufficiency.
See this image and copyright information in PMC

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