ArticleThe Journal of clinical endocrinology and metabolism2014
Cortisol as a marker for increased mortality in patients with incidental adrenocortical adenomas.
Article in The Journal of clinical endocrinology and metabolism, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 116 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Morbidity and Mortality in Patients With Adrenal Incidentalomas With and Without Autonomous Cortisol Secretion
Metabolic, Pressor and Neuropsychological Effects of Metyrapone Treatment in Patients With Hypercortisolism
Who cites it
116 citing papers in PubMed, 3 syntheses or guidelines pooled it, 259 citations in OpenAlex.
- Cardiometabolic comorbidities and cardiovascular events in "non-functioning" adrenal incidentalomas: a systematic review and meta-analysis.Journal of endocrinological investigation · 2024Pooled it
- Evaluating the efficacy of surgical and conservative approaches in mild autonomous cortisol secretion: a meta-analysis.Frontiers in endocrinology · 2024Pooled it
- Comparison of adrenalectomy with conservative treatment on mild autonomous cortisol secretion: a systematic review and meta-analysis.Frontiers in endocrinology · 2024Pooled it
- Adrenalectomy Improves Blood Pressure and Metabolic Control in Patients With Possible Autonomous Cortisol Secretion: Results of a RCT.Frontiers in endocrinology · 2022Trial
- Relacorilant, a Selective Glucocorticoid Receptor Modulator, Induces Clinical Improvements in Patients With Cushing Syndrome: Results From A Prospective, Open-Label Phase 2 Study.Frontiers in endocrinology · 2021Trial
- Trial
- The cardiometabolic significance of post-dexamethasone cortisol levels below the MACS threshold in adrenal incidentaloma.Endocrine · 2026Article
- Telomere length in patients with non-functional adrenal incidentalomas.Endocrine journal · 2026Article
- Comparison of Cardiometabolic Profiles in Patients with Nonfunctioning Adrenal Incidentalomas and Mild Autonomous Cortisol Secretion.Journal of clinical medicine · 2026Article
- Hypercortisolism: Causes, Consequences and Clinical Significance - A Review of Pathophysiology.Diabetes, obesity & metabolism · 2026Review
- Adrenalectomy improves cardiovascular profile in patients with mild autonomous cortisol secretion: extension of a multicenter randomized controlled trial to 12 months.Journal of endocrinological investigation · 2026Article
- Hair cortisol outperforms urinary free cortisol in diagnosing Cushing's syndrome: a cross-sectional study.Hormones (Athens, Greece) · 2026Article
- Article
- Adrenalectomy Improves Muscle Strength in Patients with Mild Autonomous Cortisol Secretion: A Comparative Study.Medicina (Kaunas, Lithuania) · 2026Article
- Investigating Endogenous Hypercortisolism Prevalence in a U.S. Population With Resistant Hypertension: MOMENTUM Rationale and Design.JACC. Advances · 2026Article
- Consensus on the diagnosis of Cushing's disease: a collaborative statement from the Korean Endocrine Society and Japan Endocrine Society.Endocrine journal · 2026Article
- Recent progress in pathophysiology of cortisol-producing adrenal tumor.Endocrine journal · 2026Review
- Mild autonomous cortisol secretion and brain function: cognitive, structural, and functional correlates.Frontiers in endocrinology · 2026Observational
- Development of a prediction model by combining tumor diameter and clinical parameters of adrenal incidentaloma.Endocrine journal · 2025Article
- Review
56 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
contextIncidental benign adrenocortical adenomas, adrenal incidentalomas are found in 4.5% of abdominal computed tomography scans, with the incidence increasing to 10% in patients older than 70 years of age. These incidentalomas frequently show evidence of excess cortisol secretion but without overt Cushing's syndrome. The mortality rate is increased in Cushing's syndrome.
objectiveThis study sought to investigate whether patients with adrenal incidentalomas have an increased mortality.
designThis was a retrospective, longitudinal cohort study.
settingThe study was carried out in an Endocrine Investigation Unit in a University Teaching Hospital. PATIENTS: Two hundred seventy-two consecutive patients with an incidental adrenal mass underwent a dedicated diagnostic protocol, which included dexamethasone testing for hypercortisolism between 2005 and 2013. Overall survival was assessed in 206 patients with a benign, adrenocortical adenoma.
main outcome measuresSurvival analysis was carried out by using Kaplan-Meier curves and the effect of dexamethasone cortisol estimated by Cox-regression analysis. Cause-specific mortality was ascertained from death certificates and compared with local and national data.
resultsEighteen of 206 patients died and the mean time (SD) from diagnosis to death was 3.2 (1.7) years. Seventeen of 18 patients who died had a post dexamethasone cortisol >1.8 μg/dL and there was a significant decrease in survival rate with increasing dexamethasone cortisol levels (P = .001). Compared with the <1.8 μg/dL group, the hazard ratio (95% confidence interval) for the 1.8-5 μg/dL group was 12.0 (1.6-92.6) whereas that of the >5 μg/dL group was 22.0 (2.6-188.3). Fifty percent and 33% of deaths were secondary to circulatory or respiratory/infective causes, respectively.
conclusionsPATIENTS with adrenal incidentalomas and a post-dexamethasone serum cortisol >1.8 μg/dL have increased mortality, mainly related to cardiovascular disease and infection.
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.