Obesity Associated With Worse Outcomes in Patients With Adrenal Insufficiency

Among patients hospitalized for adrenal insufficiency, comorbid obesity was found to be associated with exacerbation of certain complications including acute kidney injury and acute respiratory failure, according to study results presented at the 30th Annual Scientific and Clinical Congress of the American Association of Clinical Endocrinologists (ENVISION 2021).

Investigators reviewed data from the 2018 Nationwide Inpatient Sample to ascertain the association of obesity with outcomes of patients hospitalized for adrenal insufficiency. A total of 8980 hospitalizations for adrenal insufficiency were identified through principal diagnostic codes; this cohort was then divided based on a secondary diagnosis of obesity. The investigators compared outcomes of patients with vs without obesity, including inpatient mortality, septic shock, acute myocardial infarction, acute respiratory failure, acute pulmonary edema, length of hospital stay, and cost of hospitalization. Analyses were adjusted to correct for confounding biodemographic factors, hospital variables, and comorbidities.

Among patients admitted for adrenal insufficiency in 2018, 15.9% had comorbid obesity. Overall, there were more women than men; the proportion of women in the group with obesity, however, was greater than the proportion of women in the group without obesity (76.5% vs 58.4%; P <.001). The mean age of patients with obesity was lower than that of patients without obesity (56.5 years vs 58.1 years; P <.001), and patients with obesity were more often Black and Hispanic compared with patients without obesity.

In adjusted analyses, comorbid obesity was not associated with risk for inpatient mortality (adjusted odds ratio [aOR] 0.95; 95% CI, 0.22-4.16; P =.949), mean hospital stay (5.0 days vs 4.5 days; P =.150), or cost of hospitalization ($10,032 vs $10,649; P =.640). Obesity was associated with higher rates of acute kidney injury (aOR 1.44; 95% CI, 1.09-1.89; P =.009) and acute respiratory failure (aOR 2.28; 95% CI, 1.48-3.53; P <.001).

The researchers concluded that patients hospitalized for adrenal insufficiency who have comorbid obesity have significantly higher odds of complications including acute kidney injury and acute respiratory failure. The investigators suggested that obesity may exacerbate underlying comorbidities and affect the rate and outcome of future hospital admissions.

Reference

Alabi O, Muojieje C, Ojemolon P, et al. Association of obesity with outcomes of patients with adrenal insufficiency: a nationwide retrospective analysis. Presented at: 2021 AACE Virtual Annual Meeting, May 26-29, 2021.