{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T20:50:08Z","timestamp":1787345408996,"version":"build-2736575974"},"reference-count":24,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Horm Metab Res"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Based on recent data, a total number of about 29 000 patients with adrenal\n                    insufficiency can be calculated for Germany, and about 1500 fatalities due to\n                    adrenal crises have to be expected within the next decade. Management of adrenal\n                    crises is still unsatisfactory. The objectives of this study were to establish\n                    consensus for diagnostic criteria, prevention strategies, and treatment\n                    recommendations for adrenal crises. The study was conducted from January 2022 to\n                    April 2023, using Delphi technique. Four rounds of questionnaires were sent to\n                    45 experts, selected by a coordinating group on behalf of the adrenal section of\n                    the German Society of Endocrinology. The survey was implemented online using the\n                    REDCap web application. Responses were captured anonymously. During the Delphi\n                    process the expert panel developed diagnostic criteria to identify patients\n                    likely to have an adrenal crisis. Education about adrenal insufficiency among\n                    patients as well as non-endocrine medical personnel were regarded as highly\n                    important. It was suggested that recommendations for the management of adrenal\n                    insufficiency have to be simplified and made widely available. This study\n                    provides pragmatic strategies to identify and treat patients prone to adrenal\n                    crisis, thereby highlighting the need for an improved management of patients\n                    with adrenal insufficiency.<\/jats:p>","DOI":"10.1055\/a-2130-1938","type":"journal-article","created":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T18:50:07Z","timestamp":1691693407000},"page":"10-15","source":"Crossref","is-referenced-by-count":13,"title":["Adrenal Crisis \u2013 Definition, Prevention and Treatment:\n                Results from a Delphi Survey"],"prefix":"10.1055","volume":"56","author":[{"given":"Tina","family":"Kienitz","sequence":"additional","affiliation":[{"name":"Endocrinology in Charlottenburg, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6932-333X","authenticated-orcid":false,"given":"Nicole","family":"Bechmann","sequence":"additional","affiliation":[{"name":"Institute of Clinical Chemistry and Laboratory Medicine, University\n                    Hospital Carl Gustav Carus Dresden, Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo","family":"Deutschbein","sequence":"additional","affiliation":[{"name":"Medicover Oldenburg MVZ, Oldenburg, Germany"},{"name":"Division of Endocrinology and Diabetes, University Hospital Wurzburg,\n                    Department of Internal Medicine I, Wurzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Hahner","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetes, University Hospital Wurzburg,\n                    Department of Internal Medicine I, Wurzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Honegger","sequence":"additional","affiliation":[{"name":"Neurosurgery, Eberhard-Karls-Universitat Tubingen, Medizinische\n                    Fakultat, T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Kroiss","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine IV, University Hospital Munich, Munich,\n                    Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4028-1671","authenticated-orcid":false,"given":"Marcus","family":"Quinkler","sequence":"additional","affiliation":[{"name":"Endocrinology in Charlottenburg, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nada","family":"Rayes","sequence":"additional","affiliation":[{"name":"Department of Visceral, Transplant, Thoracic and Vascular Surgery,\n                    University Hospital Leipzig, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Reisch","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine IV, University Hospital Munich, Munich,\n                    Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5362-7075","authenticated-orcid":false,"given":"Holger Sven","family":"Willenberg","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Rostock University Medical\n                    Center, Rostock, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gesine","family":"Meyer","sequence":"additional","affiliation":[{"name":"Goethe University Frankfurt, University Hospital, Medical Clinic 1,\n                    Division of Endocrinology, Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,8,10]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1530\/EJE-09-0884","article-title":"Epidemiology of adrenal crisis in chronic adrenal insufficiency: The need for\n                    new prevention strategies","volume":"162","author":"S Hahner","year":"2010","journal-title":"Eur J Endocrinol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1210\/jc.2014-3191","article-title":"High incidence of adrenal crisis in educated patients with chronic adrenal\n                    insufficiency: A prospective study","volume":"100","author":"S Hahner","year":"2015","journal-title":"J Clin Endocrinol Metab"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1530\/EJE-09-0559","article-title":"Adrenal crisis in treated Addison\u2019s disease: A predictable but\n                    under-managed event","volume":"162","author":"K White","year":"2010","journal-title":"Eur J Endocrinol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1111\/cen.13043","article-title":"Addison\u2019s disease with polyglandular autoimmunity carries a more than\n                    2\u00b75-fold risk for adrenal crises: German Health insurance data\n                    2010-2013","volume":"85","author":"G Meyer","year":"2016","journal-title":"Clin Endocrinol (Oxf)"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"4849","DOI":"10.1210\/jc.2006-0076","article-title":"Premature mortality in patients with Addison\u2019s disease: a\n                    population-based study","volume":"91","author":"R Bergthorsdottir","year":"2006","journal-title":"J Clin Endocrinol Metab"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1111\/j.1365-2265.2008.03340.x","article-title":"Increased death risk and altered cancer incidence pattern in patients with\n                    isolated or combined autoimmune primary adrenocortical insufficiency","volume":"69","author":"S Bensing","year":"2008","journal-title":"Clin Endocrinol (Oxf)"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"1466","DOI":"10.1210\/jc.2012-4059","article-title":"Deaths among adult patients with hypopituitarism: hypocortisolism during acute\n                    stress, and de novo malignant brain tumors contribute to an increased\n                    mortality","volume":"98","author":"P Burman","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"339e1","DOI":"10.1016\/j.amjmed.2015.08.021","article-title":"Adrenal crisis: still a deadly event in the 21st century","volume":"129","author":"TH K Puar","year":"2016","journal-title":"Am J Med"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"E2715","DOI":"10.1210\/jc.2014-2957","article-title":"Increased mortality in patients with congenital adrenal hyperplasia due to\n                    21-hydroxylase deficiency","volume":"99","author":"H Falhammar","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"key":"ref10","first-page":"2226","article-title":"Nationellt kort vid binjurebarkssvikt","volume":"108","author":"P Dahlqvist","year":"2011","journal-title":"Lakartidningen"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"R165","DOI":"10.1530\/EJE-13-0450","article-title":"Therapy of endocrine disease: Perspectives on the management of adrenal\n                    insufficiency: clinical insights from across Europe","volume":"169","author":"A Grossman","year":"2013","journal-title":"Eur J Endocrinol"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1111\/cen.12378","article-title":"Saving lives of patients with adrenal insufficiency: a pan-European\n                    initiative?","volume":"80","author":"M Quinkler","year":"2014","journal-title":"Clin Endocrinol 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Harris","year":"2009","journal-title":"J Biomed Inform"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"R115","DOI":"10.1530\/EJE-14-0824","article-title":"Extensive expertise in endocrinology. Adrenal crisis","volume":"172","author":"B Allolio","year":"2015","journal-title":"Eur J Endocrinol"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1210\/jc.2015-1710","article-title":"Diagnosis and treatment of primary adrenal insufficiency: an endocrine society\n                    clinical practice guideline","volume":"101","author":"S R Bornstein","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1111\/joim.12162","article-title":"Consensus statement on the diagnosis, treatment and follow-up of patients with\n                    primary adrenal insufficiency","volume":"275","author":"E S Husebye","year":"2014","journal-title":"J Intern Med"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"371","DOI":"10.7861\/clinmed.2019-0324","article-title":"Guidance for the prevention and emergency management of adult patients with\n                    adrenal insufficiency","volume":"20","author":"H Simpson","year":"2020","journal-title":"Clin Med"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1111\/cen.13608","article-title":"Management of adrenal emergencies in educated patients with adrenal\n                    insufficiency \u2013 a prospective study","volume":"89","author":"S Burger-Stritt","year":"2018","journal-title":"Clin Endocrinol (Oxf)"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1530\/EJE-12-1094","article-title":"A glucocorticoid education group meeting: an effective strategy for improving\n                    self-management to prevent adrenal crisis","volume":"169","author":"HJW J Repping-Wuts","year":"2013","journal-title":"Eur J Endocrinol"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1055\/a-1217-7208","article-title":"Therapeutic patient education for adrenal insufficiency under COVID-19 pandemic\n                    conditions","volume":"129","author":"T Kienitz","year":"2021","journal-title":"Exp Clin Endocrinol Diabetes"},{"key":"ref24","first-page":"882","article-title":"Adrenal cortical insufficiency \u2013 A life threatening illness with\n                    multiple etiologies","volume":"110","author":"M Quinkler","year":"2013","journal-title":"Dtsch Arztebl Int"},{"key":"ref25","first-page":"12","article-title":"New aspects of glucocorticoid substitution in adrenal insufficiency","volume":"63","author":"T Kienitz","year":"2022","journal-title":"Internist"}],"container-title":["Hormone and Metabolic Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2130-1938.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T08:21:17Z","timestamp":1730794877000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2130-1938"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,10]]},"references-count":24,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2024,1,3]]},"published-print":{"date-parts":[[2024,1]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2130-1938","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0018-5043","1439-4286"],"issn-type":[{"value":"0018-5043","type":"print"},{"value":"1439-4286","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,10]]}}}