Adrenal function in patients with community-acquired pneumonia

¹ Dept of Respiratory Medicine, St. Luke's International Hospital, Tokyo, Japan
² Dept of General Internal Medicine, St. Luke's International Hospital, Tokyo, Japan
³ Dept of Anesthesiology, Fukui Red Cross Hospital, Fukui, Japan

^* To whom correspondence should be addressed. E-mail: gotoshin{at}luke.or.jp.

	Abstract

Adrenal insufficiency has been said to occur frequently in severe sepsis and septic shock.

Is the adrenal function related to the severity of community-acquired pneumonia?

Sixty-four Japanese patients with community-acquired pneumonia were consecutively enrolled in this study from 2005 to 2006. Serum adrenocorticotropic hormone (ACTH) and cortisol were measured in each subject, as was the response of cortisol secretion to the administration of 250 µg of cosyntropin. Analyses comparing these values with the score calculated by the Pneumonia Patient Outcomes Research Team (PORT) cohort study, the number of in-hospital deaths, and the length of hospital stay were performed.

As the PORT score increased, serum ACTH and cortisol increased (Spearman's rank correlation coefficient: =0.371, p<0.05 and =0.396, p<0.05, respectively), while the response of cortisol secretion to the administration of cosyntropin decreased (= -0.273, p<0.05). In the analysis by receiver operating characteristic (ROC) curves, adrenal dysfunction was related significantly to both the number of in-hospital deaths and the length of hospital stay.

Adrenal dysfunction was shown to correlate with the PORT score and the clinical outcomes, while adrenal insufficiency defined by the cosyntropin stimulation test was rare in our study.

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