Adrenal insufficiency in the surgical intensive care unit patient

J Trauma. 1997 Jan;42(1):27-31. doi: 10.1097/00005373-199701000-00006.


Background: Adrenocortical dysfunction is unusual in the unselected critically ill patient. Case reports document a state of corticosteroid responsive vasopressor dependence, resembling the systemic inflammatory response syndrome. The exact incidence of this disorder is unknown.

Methods: We prospectively studied the incidence of adrenal insufficiency during a 9-month period in a surgical intensive care unit (ICU) population. Trauma, general surgery, urology, and gynecologic-oncology patients were included. Patients who met criteria were given a cosyntropin stimulation test.

Results: Overall, the incidence of adrenal insufficiency was 0.66%. In the subgroup of patients with greater than 14 days stay in the ICU, 6% were found to have adrenal insufficiency. In patients aged more than 55 years and with ICU stays of 14 days or greater, 11% were adrenally insufficient.

Conclusions: Screening of critically ill patients for adrenal insufficiency, particularly those with prolonged ICU stay and age greater than 55 years, is warranted.

Publication types

  • Comparative Study

MeSH terms

  • Adrenocorticotropic Hormone / blood
  • Adrenocorticotropic Hormone / deficiency*
  • Adult
  • Aged
  • Aged, 80 and over
  • Aging / blood
  • Cosyntropin
  • Hospital Mortality
  • Humans
  • Incidence
  • Intensive Care Units
  • Length of Stay
  • Middle Aged
  • Prospective Studies
  • Wounds and Injuries / blood*


  • Cosyntropin
  • Adrenocorticotropic Hormone