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Digestive Diseases and Sciences
Erschienen in: Digestive Diseases and Sciences 4/2017

07.02.2017 | Original Article

Relative Adrenal Insufficiency in Patients with Cirrhosis: A Systematic Review and Meta-Analysis

verfasst von: Gaeun Kim, Ji Hye Huh, Kyong Joo Lee, Moon Young Kim, Kwang Yong Shim, Soon Koo Baik

Erschienen in: Digestive Diseases and Sciences | Ausgabe 4/2017

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Abstract

Background

Relative adrenal insufficiency (RAI) is frequently observed in patients with cirrhosis. We sought to identify evidence in the literature regarding the impact of RAI on clinical outcomes in cirrhotic patients.

Methods

We conducted a systematic review (SR) and meta-analysis (MA) using the Ovid-MEDLINE, EMBASE, and Cochrane Library databases to identify relevant studies in the literature.

Results

Of the 182 studies identified, 16 were eligible according to our inclusion criteria. The prevalence of RAI was 49.4% (744/1507), and cirrhotic patients with acute critical illnesses such as sepsis were more likely to have RAI compared to those without critical illnesses (P < 0.001). With respect to clinical outcomes, patients with RAI had poorer survival rates and an increased risk of complications such as bleeding and hepatorenal syndrome compared to those without RAI. Corticosteroid therapy had a beneficial effect on critically ill cirrhotic patients in terms of hospital survival rate.

Conclusions

Based on this SR and MA, critically ill patients with cirrhosis have a high risk of RAI, and the presence of RAI is related to a poor prognosis and occurrence of cirrhotic complications.
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Metadaten
Titel
Relative Adrenal Insufficiency in Patients with Cirrhosis: A Systematic Review and Meta-Analysis
verfasst von
Gaeun Kim
Ji Hye Huh
Kyong Joo Lee
Moon Young Kim
Kwang Yong Shim
Soon Koo Baik
Publikationsdatum
07.02.2017
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences / Ausgabe 4/2017
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-017-4471-8

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