Table 1.
Main characteristics of included studies
| First Author | Year, Country | Study Design | N (AI/non-AI) | Population | Summary MELD score | Summary CP score or class (A/B/C) | ACTH stim test | AI def† | AI prev |
|---|---|---|---|---|---|---|---|---|---|
| Acevedo | 2013, Spain | PC | 143 (37/106) | Hospitalized – ADC | 18 ± 7 | 9 ± 2 | SD-SST | Δ TC | 26% |
| Albert | 2019, Spain | CS | 39 (19/20) | Hospitalized – ADC | n/a | 9 ± 2 (6/18/15) | SD-SST | Δ TC, Peak TC, SC | 26%, 23%, 31% |
| Araz | 2016, Turkey | CS | 110 (23/87) | Outpatient – stable cirrhosis | n/a | 7 ± 2 (56/32/22) | SD-SST | Peak FC | 15% |
| Chawlani | 2015, India | PC | 120 (69/51) | Hospitalized – non-septic cirrhosis | 20 (6–40) | 10 (6, 13) | SD-SST | Combo: Δ TC or Peak TC | 58% |
| Cholongitas | 2017, Greece | PC | 113 (34/79) | Hospitalized – liver transplant evaluation | 14 ± 5 | 8 ± 2 | SD-SST | Δ TC, SC | 30%, 22% |
| Fede | 2015, UK/Italy | CS | 121 (46/75) | Hospitalized – non-septic ADC | 14 (6–25) | 9 (5, 21) | LD-SST | Peak TC, Peak FC | 38%, 6% |
| Fede | 2011, UK/Italy | CS | 101 (38/63) | Hospitalized – non-septic cirrhosis | 14 (11, 18) | 8 (6, 10) (29/38/34) | LD-SST | Δ TC, Peak TC | 59%, 38% |
| Fede | 2014, UK | PC | 79 (27/52) | Hospitalized – liver transplant evaluation or non-septic ADC | 15 (13, 20) | 8 (7, 9) (19/43/17) | LD-SST | Δ TC, Peak TC, Peak FC | 71%, 34%, 28% |
| Galbois | 2010, France | CS | 88 (29/59) | Hospitalized – non-septic ADC | 16 ± 8 | 10 ± 2 (4/24/60) | SD-SST | Δ TC, Peak TC, SC | 11%, 11%, 9% |
| Jang | 2014, South Korea | PC | 54 (13/41) | Hospitalized non-septic cirrhosis | 11 ± 5 | 8 ± 2 (18/22/14) | SD-SST | Δ TC | 24% |
| Kalambokis | 2021, Greece | PC | 95 (27/68) | Outpatient – stable cirrhosis | 14 ± 4 | 9 ± 2 (31/38/26) | SD-SST, LD-SST | Δ TC, Peak TC, SC | 24%, 9%, 20% |
| Park | 2018, South Korea | CS | 69 (24/45) | Hospitalized – non-septic cirrhosis | n/a | 8 ± 2 (19/37/13) | SD-SST | Peak TC | 35% |
| Piano | 2020, Italy | PC | 160 (78/82) | Hospitalized - ADC | 18 ± 7 | 9 ± 2 | SD-SST | Δ TC | 49% |
| Risso | 2015, Italy | PC | 93 (30/63) | Hospitalized – non-septic cirrhosis with ascites | 19 (15, 23) | 9 (8, 10) (0/50/43) | SD-SST | Δ TC, Peak TC | 15%, 32% |
| Singh | 2018, India | PC | 66 (31/35) | Hospitalized – non-septic cirrhosis with ascites | n/a | 11 ± 2 (1/15/50) | SD-SST | Combo: Δ TC or Peak TC | 47% |
| Siramolpiwat | 2021, Thailand | PC | 115 (35/80) | Hospitalized – non-septic ADC | 16 ± 7 | 8 ± 2 (18/62/35) | SD-SST | Δ TC | 30% |
| Spadaro | 2015, Italy | CS | 81 (26/55) | Hospitalized – non-septic cirrhosis without ADC | n/a | 8 (5–12) (20/39/22) | LD-SST | Peak TC | 32% |
| Tan | 2010, Australia | PC | 43 (25/18) | Outpatient – stable cirrhosis | 13 (n/a) | 9 (5–13) (9/13/21) | SD-SST | Δ TC, Peak TC, Peak FC | 47%, 42%, 12% |
| Theocharidou | 2019, Greece | CS | 61 (27/34) | Outpatient – stable cirrhosis | 15 ± 7 | n/a (17/28/16) | LD-SST | Δ TC, Peak TC, Peak FC | 44%, 18%, 0% |
| Thevenot | 2012, France | PC | 95 (47/48) | Hospitalized – non-septic cirrhosis | n/a | n/a (34/29/32) | SD-SST, LD-SST | Δ TC, Peak TC | 49%, 27% |
| Triantos | 2011, Greece | PC | 50 (24/26) | Hospitalized – non-septic cirrhosis | 16 (6–29) | 9 (5–15) (10/18/22) | SD-SST, LD-SST | Peak TC | 48% |
| Wentworth | 2021, USA | PC | 95 (37/58) | Hospitalized – non-septic cirrhosis | 17 (13, 21) | 9 (8, 11) (0/51/44) | SD-SST | Δ TC | 39% |
Abbreviations: ADC, acute decompensated cirrhosis; Combo, combination; CS, cross-sectional; Def, definition; FC, free cortisol; LD-SST, low-dose short synacthen test; PC, prospective cohort; Prev, prevalence; SC, salivary cortisol SD-SST, standard-dose short synacthen test; TC, total cortisol.
†
AI defined as: Δ TC < 9 μg/dL, Peak TC < 18 μg/dL, Peak FC < 1.2 μg/dL, or composite baseline SC < 0.2 μg/dL, peak salivary cortisol < 1.3 μg/dL, or delta salivary cortisol < 0.3 μg/dL.