Morbidities and mortality among hospitalized patients with hypopituitarism: Prevalence, causes and management.

IF 6.9 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Reviews in Endocrine & Metabolic Disorders Pub Date : 2024-06-01 Epub Date: 2024-05-27 DOI:10.1007/s11154-024-09888-8
Fahim Ebrahimi, Lukas Andereggen, Emanuel R Christ
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Abstract

Hypopituitarism is a highly heterogeneous multisystem disorder that can have a major impact on long-term morbidity and mortality, but even more so during acute medical conditions requiring hospitalization. Recent studies suggest a significant in-hospital burden with prolonged length of stay, increased rate of intensive care unit (ICU) admission, and initiation of mechanical ventilation - all of which may lead to an increased risk of in-hospital mortality. On the one hand, patients with hypopituitarism are often burdened by metabolic complications, including obesity, hypertension, dyslipidemia, and hyperglycemia, which alone, or in combination, are known to significantly alter relevant physiological mechanisms, including metabolism, innate and adaptive immune responses, coagulation, and wound healing, thereby contributing to adverse in-hospital outcomes. On the other hand, depending on the extent and the number of pituitary hormone deficiencies, early recognition of hormone deficiencies and appropriate management and replacement strategy within a well-organized multidisciplinary team are even stronger determinants of short-term outcomes during acute hospitalization in this vulnerable patient population. This review aims to provide an up-to-date summary of recent advances in pathophysiologic understanding, clinical implications, and recommendations for optimized multidisciplinary management of hospitalized patients with hypopituitarism.

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垂体功能减退症住院病人的发病率和死亡率:发病率、原因和管理。
垂体功能减退症是一种高度异质性的多系统疾病,可对长期发病率和死亡率产生重大影响,但在需要住院治疗的急性病中影响更大。最近的研究表明,垂体功能减退症患者住院时间延长、入住重症监护室(ICU)的比例增加以及开始使用机械通气,这些都会给患者带来沉重的负担,并可能导致院内死亡风险增加。一方面,垂体功能减退症患者通常会有代谢并发症,包括肥胖、高血压、血脂异常和高血糖,这些并发症单独或合并出现时会显著改变相关的生理机制,包括新陈代谢、先天性和适应性免疫反应、凝血和伤口愈合,从而导致不良的院内预后。另一方面,根据垂体激素缺乏的程度和数量,在一个组织良好的多学科团队中及早识别激素缺乏并采取适当的管理和替代策略,对这一易受伤害的患者群体在急性住院期间的短期预后具有更大的决定性作用。本综述旨在总结对垂体功能减退症住院患者的病理生理学认识、临床影响和多学科优化管理建议方面的最新进展。
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来源期刊
Reviews in Endocrine & Metabolic Disorders
Reviews in Endocrine & Metabolic Disorders 医学-内分泌学与代谢
CiteScore
14.70
自引率
1.20%
发文量
75
审稿时长
>12 weeks
期刊介绍: Reviews in Endocrine and Metabolic Disorders is an international journal dedicated to the field of endocrinology and metabolism. It aims to provide the latest advancements in this rapidly advancing field to students, clinicians, and researchers. Unlike other journals, each quarterly issue of this review journal focuses on a specific topic and features ten to twelve articles written by world leaders in the field. These articles provide brief overviews of the latest developments, offering insights into both the basic aspects of the disease and its clinical implications. This format allows individuals in all areas of the field, including students, academic clinicians, and practicing clinicians, to understand the disease process and apply their knowledge to their specific areas of interest. The journal also includes selected readings and other essential references to encourage further in-depth exploration of specific topics.
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