Manosroi W, et al. - Researchers conducted a seven-year retrospective study in a tertiary care medical center in order to identify simple biochemical and clinical factors and derive a predictive model to help identify hospitalized patients with biochemical adrenal insufficiency (AI) who have indeterminate 0800 h serum cortisol levels. One hundred twenty-eight inpatients were identified who had undergone low-dose or high-dose ACTH stimulation tests. Of the 128 patients (65 males, 63 females), 28.1% (36/128) had biochemical AI. Serum random cortisol < 10 μg/dL, cholesterol < 150 mg/dL, sodium < 140 mmol/L were the factors associated with biochemical AI. Among clinical factors, cirrhosis, Cushingoid appearance in those with exogenous steroid use, and CKD were significantly associated with biochemical AI. Findings suggested that these easy-to-perform biochemical tests and easy-to-assess clinical factors could help anticipate biochemical AI in hospitalized patients with high precision. Therefore, the physician should have a high suspicion index to conduct dynamic tests for AI diagnosis in those who meet the proposed model criteria.