Adrenal Insufficiency in patients with cardiogenic shock: A meta-analysis

Abstract

Background: Adrenal Insufficiency (AI) is rarely observed in patients with cardiogenic shock (CS). We aimed to identify the prevalence of AI in patients with CS and its effect on their clinical outcomes.

Aims: Our study aimed to determine the prevalence of AI in CS patients who underwent treatments for CS.

Methods: The articles concerning AI in CS were extracted for review from PubMed/Medline, Science Direct, World Wide Science.org, and Pro-Quest. The research articles included patients with CS, post-cardiac-arrest shock, out-of-hospital cardiac arrest, and CS after acute myocardial infarction. RStudio (version 1.0.136) was used for analyzing AI in CS patients.

Results: The search revealed 1463 unique publications, including 256 studies identified after screening the titles and the abstracts. Five observational cohort studies met the eligibility criteria for meta-analysis after the preliminary screening. The included studies reported a corticotropin stimulation test for AI diagnosis. The studies reportedly exhibited a low-to-fair quality. The random-effects pooled estimates indicated a 32% AI prevalence in the setting of CS [95% CI; 21%-45%; I² = 81%]. The outcomes from the included studies were statistically significant for high heterogeneity (P = 0.001). The pooled results confirmed an 11%-51% AI prevalence in CS patients.

Conclusions: This meta-analysis revealed a moderate level prevalence of AI in CS patients.

Keywords: Adrenal Insufficiency; Cardiac arrest; Cardiogenic shock; Cardiovascular; Endocrine; Meta-analysis.