The relationship between adrenal incidentalomas and mortality risk
Open accessAbstract
Objective To determine all-cause mortality risk in patients with and without adrenal incidentaloma.Methods Retrospective cohort study of patients with CT abdomen performed within 24 h of emergency room presentation at an academic medical center from January 1, 2005, to December 31, 2009, without history of adrenal disease, adrenal lab testing, or cancer. Incidentaloma cohort identified by database query of imaging reports followed by manual review and matched to no-nodule controls at 3:1 on age ± 1 year and exam date ± 3 months. Mortality ascertained by in-hospital deaths and National Death Index query. Survival analysis performed with Kaplan-Meier curves and Cox proportional hazards models.Results Among 42,575 adults with abdominal CT exams, 969 adrenal incidentaloma patients and 2907 no-nodule controls were identified. All 3876 individuals entered survival analysis with 31,182 person-years at risk (median follow-up 8.9 years [IQR, 6.9-10.7]). All-cause mortality was significantly higher among those with adrenal incidentalomas (353/969, 36.4%) compared with those without (919/2907, 31.6%; mortality difference 7.6 per 1000 person-years; multivariable-adjusted hazard ratio [aHR] 1.14; 95% CI, 1.003-1.29). Exploratory analyses, limited by missing covariates, found that adrenal incidentalomas were associated with significantly increased incidence of malignancy (aHR 1.61; 95% CI, 1.22-2.12), diabetes (aHR 1.43; 95% CI, 1.18-1.71), heart failure (aHR 1.32; 95% CI, 1.07-1.63), peripheral vascular disease (aHR 1.28; 95% CI, 1.95-1.56), renal disease (aHR 1.21; 95% CI, 1.01-1.44), and chronic pulmonary disease (aHR 1.22; 95% CI, 1.01-1.46) compared with controls.Conclusions Adrenal incidentalomas are associated with increased mortality and may represent a clinically valuable biomarker.Key points • Adrenal incidentalomas are associated with increased mortality. • Adrenal incidentaloma size is not predictive of mortality. • On exploratory analyses, adrenal incidentalomas are associated with chronic illnesses.
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Over the last 2 decades, there has been a dramatic increase in the detection of AIs; series with contemporary high-resolution CT techniques report a prevalence close to that observed at autopsy.
“Over the last 2 decades, there has been a dramatic increase in the detection of AIs; series with contemporary high-resolution CT techniques report a prevalence close to that observed at autopsy (Table 2 (36-44)).”
From Adrenal incidentaloma (2020) · cites this paper as [38]
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References 29 · Cited by 38
- Authors
- Taya, M., Paroder, V., Bellin, E., & Haramati, L. B.
- Affiliations
- Albert Einstein College of Medicine (US)
- Corresponding author
- Taya, Michio
- Venue
- European Radiology
- Published
- 2019-04-16
- Volume
- 29
- Issue
- 11
- Pages
- 6245-6255
- ISSN
- 0938-7994 (ISSN-L)
- 1432-1084
- PMC
- PMC6801004
- OpenAlex
- W2938484724
- Cited by
- 38
- References
- 29
- Citations by year
- 2026: 1 · 2025: 10 · 2024: 8 · 2023: 4 · 2022: 6 · 2021: 5 · 2020: 4
- FWCI
- 2.34
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- European Radiology (publishedVersion)
- SSRN Electronic Journal (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Center for Advancing Translational Sciences (1UL-1TR001073)
- Montefiore Medical Center Department of Radiology
- Topics
- Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Keywords
- adrenal incidentaloma, all-cause mortality, cancer risk, diabetes mellitus, heart failure, peripheral vascular disease, kidney disease, chronic lung disease, emergency department patients, survival analysis, mortality risk factors
- MeSH terms
- Adrenal Gland Neoplasms, Adult, Aged, Female, Humans, Male, Middle Aged, Retrospective Studies, Tomography, X-Ray Computed, Incidence, Proportional Hazards Models, Survival Analysis, Age Distribution
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