Management of Adrenal Emergency in Germany

Study Overview
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Brief Summary
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The management of adrenal crisis is often problematic and the time to adequate treatment is frequently delayed.The aim of the study is to evaluate the management of adrenal emergencies requiring parenteral glucocorticoid treatment by a prospective multicenter study in patients with chronic adrenal insufficiency.

Detailed Description
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Despite established hormone replacement therapy, patients with chronic adrenal insufficiency (AI) are at risk of suffering from adrenal crisis (AC). Further data suggests that the management of AC is often problematic and the time to adequate treatment is frequently delayed.The aim of the study is to evaluate the management of adrenal emergencies (AE) requiring parenteral glucocorticoid (GC) treatment by a prospective multicenter study. Patients with chronic AI receive a questionnaire on the management of emergency situations, which had to be completed and sent back in case of an emergency requiring parenteral GC administration. Furthermore, patients were contacted by phone in case of a missing response every six months.

Official Title
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Management of Adrenal Emergency in Germany - a Prospective Multicenter

Conditions
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Adrenal Insufficiency

Intervention / Treatment
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* Other: No intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥18 years Documented chronic adrenal insufficiency Established corticosteroid replacement therapy Written informed consent Exclusion Criteria: - Age <18 years

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: No intervention|No intervention|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Median time from contacting a medical professional to arrival of professional medical help | Evaluation of the median time (in minutes) from contacting a medical professional (by the patient) to arrival of professional medical help during an (adrenal) emergency. The time is documented in a questionnaire by the patients themselves (directly after the adrenal emergency). The data of all patients will be stated as median and range. | 6-36 months | 
| Median time from showing the emergency card (by a patient) to glucocorticoid-injection by a medical professional | Evaluation of the median time (in minutes) from showing the emergency card (by a patient) to glucocorticoid-injection by a medical professional. The time is documented in a questionnaire by the patients themselves (directly after the adrenal emergency). The data of all patients will be stated as median and range. | 6-36 months | 
| Median time from the beginning of symptoms to glucocorticoid-injection | Evaluation of the median time (in minutes) from the beginning of symptoms to glucocorticoid-injection during an (adrenal) emergency. The time is documented in a questionnaire by the patients themselves (directly after the adrenal emergency). The data of all patients will be stated as median and range. | 6-36 months | 
| Duration of hospitalisation (number of days at a hospital) | Evaluation of the duration of hospitalisation (number of days at a hospital) due to an adrenal emergency. The number of days is documented by the patients themselves (directly after the adrenal emergency). The data of all patients will be stated as median and range. | 6-36 months | 
| Number of patients that received an intramuscular glucocorticoid-injection | Evaluation of the number of patients that received an intramuscular glucocorticoid-injection (compared to subcutaneous administration) during an adrenal emergency. Documentation by the patients themselves directly after the adrenal emergency. | 6-36 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cause of the adrenal emergency | Evaluation of the causes of the adrenal emergencies. The causes are documented in a questionnaire by the patients themselves. The number of different causes that are stated by all patients will be evaluated. | 6-36 months | 
| Median time from the beginning of symptoms to oral dose adjustment (glucocorticoids) during an adrenal emergency | Evaluation of the median time (in minutes) from the beginning of symptoms to oral dose adjustment (glucocorticoids). The time is documented in a questionnaire by the patients themselves (directly after the adrenal emergency). The data of all patients will be stated as median and range. | 6-36 months | 
| Median time from the beginning of symptoms to contacting a medical professional | Evaluation of the median time (in minutes) from the beginning of symptoms to contacting a medical professional during an adrenal emergency. The time is documented in a questionnaire by the patients themselves (directly after the adrenal emergency). The data of all patients will be stated as median and range. | 6-36 months | 
| Symptoms of the adrenal emergency | Evaluation of the symptoms during the adrenal emergencies. The symptoms are documented in a questionnaire by the patients themselves. The number of different symptoms that are stated by all patients will be evaluated. | 6-36 months | 
| Median amount of additionally oral ingested glucocorticoids during the adrenal emergency | Evaluation of the median amount of additionally oral ingested glucocorticoids (in mg) during the adrenal emergency. The amount of glucocorticoids is documented in a questionnaire by the patients themselves (directly after the adrenal emergency). The data of all patients will be stated as median and range. | 6-36 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Adrenal Insufficiency, Adrenal crisis, Adrenal emergency, Glucocorticoid injection