Mortality in patients with adrenal insufficiency: a protocol for a systematic review and meta-analysis
Introduction Adrenal insufficiency (AI) is a rare disorder characterised by an impaired secretion of glucocorticoids from the adrenal glands. Treatment strategies for AI have developed over time with reduced glucocorticoid replacement doses and improved circadian exposure regimens, but whether this...
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BMJ Publishing Group
2024-01-01
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Series: | BMJ Open |
Online Access: | https://bmjopen.bmj.com/content/14/1/e076582.full |
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author | Eva Hessman Bright I Nwaru Emanuele Bobbio Daniela Esposito Francesca Allosso Konstantinos Dalakas Ragnhildur Bergthorsdottir Dimitrios Chantzichristos Daniela Pasquali Gudmundur Johannsson |
author_facet | Eva Hessman Bright I Nwaru Emanuele Bobbio Daniela Esposito Francesca Allosso Konstantinos Dalakas Ragnhildur Bergthorsdottir Dimitrios Chantzichristos Daniela Pasquali Gudmundur Johannsson |
author_sort | Eva Hessman |
collection | DOAJ |
description | Introduction Adrenal insufficiency (AI) is a rare disorder characterised by an impaired secretion of glucocorticoids from the adrenal glands. Treatment strategies for AI have developed over time with reduced glucocorticoid replacement doses and improved circadian exposure regimens, but whether this has resulted in better survival is unknown. The main purpose of this systematic review is to gather and synthesise available evidence on long-term mortality in patients with AI. The secondary aim is to study causes of death, with focus on cardiovascular and infectious diseases, in AI patients.Methods and analysis Studies published from the inception of respective databases (Medline, Embase, Cochrane and Web of Science) until the end of May 2023 will be systematically synthetised. Observational studies with a reference population will be included, and their quality will be assessed using the Newcastle-Ottawa scale. Data collected will be narratively integrated and a meta-analysis will be performed to pool data from studies considered homogeneous. The systematic review will be reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. This will be the first systematic review assessing mortality and causes of death in AI patients. The findings of this systematic review will be of value for both patients and healthcare providers.Ethics and dissemination This systematic review does not require ethical approval or informed consent because it will be based on previously published data only and does not implicate any direct contact with individual patients. The research results will be presented at scientific conferences and submitted for publication in an internationally recognised peer-reviewed scientific journal.PROSPERO registration number CRD42023416253. |
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institution | Directory Open Access Journal |
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language | English |
last_indexed | 2024-03-07T21:58:12Z |
publishDate | 2024-01-01 |
publisher | BMJ Publishing Group |
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series | BMJ Open |
spelling | doaj.art-7b53c90d80204ae68018b0d231e463142024-02-24T11:40:07ZengBMJ Publishing GroupBMJ Open2044-60552024-01-0114110.1136/bmjopen-2023-076582Mortality in patients with adrenal insufficiency: a protocol for a systematic review and meta-analysisEva Hessman0Bright I Nwaru1Emanuele Bobbio2Daniela Esposito3Francesca Allosso4Konstantinos Dalakas5Ragnhildur Bergthorsdottir6Dimitrios Chantzichristos7Daniela Pasquali8Gudmundur Johannsson9Biomedical Library, Gothenburg University Library, University of Gothenburg, Gothenburg, SwedenKrefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenDepartment of Cardiology, Sahlgrenska University Hospital, Gothenburg, SwedenDepartment of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenDepartment of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, ItalyDepartment of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenDepartment of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenDepartment of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenDepartment of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, ItalyDepartment of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenIntroduction Adrenal insufficiency (AI) is a rare disorder characterised by an impaired secretion of glucocorticoids from the adrenal glands. Treatment strategies for AI have developed over time with reduced glucocorticoid replacement doses and improved circadian exposure regimens, but whether this has resulted in better survival is unknown. The main purpose of this systematic review is to gather and synthesise available evidence on long-term mortality in patients with AI. The secondary aim is to study causes of death, with focus on cardiovascular and infectious diseases, in AI patients.Methods and analysis Studies published from the inception of respective databases (Medline, Embase, Cochrane and Web of Science) until the end of May 2023 will be systematically synthetised. Observational studies with a reference population will be included, and their quality will be assessed using the Newcastle-Ottawa scale. Data collected will be narratively integrated and a meta-analysis will be performed to pool data from studies considered homogeneous. The systematic review will be reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. This will be the first systematic review assessing mortality and causes of death in AI patients. The findings of this systematic review will be of value for both patients and healthcare providers.Ethics and dissemination This systematic review does not require ethical approval or informed consent because it will be based on previously published data only and does not implicate any direct contact with individual patients. The research results will be presented at scientific conferences and submitted for publication in an internationally recognised peer-reviewed scientific journal.PROSPERO registration number CRD42023416253.https://bmjopen.bmj.com/content/14/1/e076582.full |
spellingShingle | Eva Hessman Bright I Nwaru Emanuele Bobbio Daniela Esposito Francesca Allosso Konstantinos Dalakas Ragnhildur Bergthorsdottir Dimitrios Chantzichristos Daniela Pasquali Gudmundur Johannsson Mortality in patients with adrenal insufficiency: a protocol for a systematic review and meta-analysis BMJ Open |
title | Mortality in patients with adrenal insufficiency: a protocol for a systematic review and meta-analysis |
title_full | Mortality in patients with adrenal insufficiency: a protocol for a systematic review and meta-analysis |
title_fullStr | Mortality in patients with adrenal insufficiency: a protocol for a systematic review and meta-analysis |
title_full_unstemmed | Mortality in patients with adrenal insufficiency: a protocol for a systematic review and meta-analysis |
title_short | Mortality in patients with adrenal insufficiency: a protocol for a systematic review and meta-analysis |
title_sort | mortality in patients with adrenal insufficiency a protocol for a systematic review and meta analysis |
url | https://bmjopen.bmj.com/content/14/1/e076582.full |
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