Dehydroepiandrosterone, dehydroepiandrosterone-sulfate, and cortisol concentrations in intensive care unit patients

Study Objective: This purpose of this study was to determine whether severi ty of illness, as defined by the intensive care unit (ICU) admission APACHE II (updated Acute Physiology and Chronic Health Evaluation) score, is corr elated with early morning cortisol, dehydroepiandrosterone (DHEA), and/or d ehydroepiandrosterone-sulfate (DHEA-S) concentrations. Design: Early morning concentrations of DHEA, DHEA-S, and cortisol were det ermined within 24 hrs of admission and compared with admission APACHE II sc ores. Setting: Medical (MICU), neurologic (NICU), and surgical (SICU) intensive c are units of the University of Pittsburgh Medical Center, Patients: A total of 191 men and women ranging in age from 16 to 93 yrs, Al l had been admitted to an ICU, Measurements and Main Results: Statistically significant correlations betwe en APACHE II scores and cortisol were observed for women in the MICU and SI CU (r = .68, p = .0001; r = .35 p = .017, respectively) and for men in the NICU (r = .55, p = .003) and the SICU (r = .29, p = .036), The correlations between APACHE II scores and DHEA concentration data were statistically si gnificant for women in the MICU (r = .37, p = .047) and SICU (r = .43, p = .002), as was the correlation between APACHE II and DHEA-S concentrations a mong women in the SICU (r = .38, p = .008), Although not statistically sign ificant, a similar relationship was observed in the smaller group of NICU w omen (r = .40, p = .099), Each correlation was essentially unchanged when a djusted for age. Conclusion: These data show a positive correlation between APACHE II and co rtisol concentrations in all groups except the MICU men. Also evident is th e positive correlation between APACHE II scores and DHEA and DHEA-S concent rations in women, but not in men.