Increased mortality in primary adrenal insufficiency: a systematic review and meta-analysis
Authors' conclusion
Mortality in patients with PAI was increased 2.5-fold compared to the reference population.
Study context
- Population
- Adults with primary adrenal insufficiency (PAI), including congenital adrenal hyperplasia (CAH); observational studies of mortality vs a reference population (Medline, Cochrane CENTRAL, Web of Science, Embase)9 reports
- Participants
- 13,969 adults
- Comparison
- Adults with PAI vs reference population
- Outcome
- Mortality
Pooled result
As reported in the abstract
Pooled HR for mortality (4 studies), 95% CI 1.47-4.31, I2 = 86.1%
2.51
Pooled standardized mortality ratio (SMR) for mortality (3 studies), 95% CI 0.99-6.28, I2 = 97.9%
2.49
Further pooled results
| Outcome | Pooled HR (95% CI) | |
|---|---|---|
| Mortality, CAH sub-analysisCAHvs Reference populationI2 = 90.3% | 2.88 (1.38–6.01) | |
| 0.10.31310Pooled hazard ratio (log scale) |
- Mortality, CAH sub-analysis — Main cause of death
- adrenal crisis
Original publication
Increased mortality in primary adrenal insufficiency: a systematic review and meta-analysis. Eur J Endocrinol. Published 12 September 2025. doi:10.
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