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Purpose <p>Adrenocortical insufficiency (AI), one of the most common hormonal deficiencies, is associated with significant mortality due to acute precipitation of adrenal crisis. This study aims to assess trends and disparities in mortality due to AI in the United States of America (US) from 1999 to 2020.</p> Methods <p>Death certificate data pertaining to AI-related mortality were retrieved from the CDC WONDER database. Crude mortality rates (CMRs) and age-adjusted mortality rates (AAMRs) were calculated per 1,000,000 population. Annual percentage change (APC) and average APC were used to assess temporal trends using Joinpoint regression.</p> Results <p>A total of 26,791 deaths occurred due to AI in the US from 1999 to 2020, with an increasing overall trend (average APC: 1.68). Males (5.89) had a higher AAMR than females (5.52). Non-Hispanic (NH) American Indians (9.62) had the highest AAMR and Hispanics (4.11) had the lowest. CMRs in older adults (19.81) aged 65 + years were ten times higher than those of young adults (2.37) aged 25–64 years. Rural areas (6.72) had higher mortality than urban areas (5.43). The Midwest (6.27) reported the highest mortality among the census regions, and the Northeast (4.91) the least. The states with the highest AAMRs were North Dakota (11.25) and Oklahoma (9.54), while Florida (3.32) and Nevada (2.99) had the lowest.</p> Conclusion <p>Adults in the US have shown increasing mortality burden due to AI, with men, NH American Indians, older adults and rural populations being the most high-risk. Targeted strategies need to be developed to curb the rise in mortality rates.</p>

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Temporal trends and demographic and regional disparities in adrenocortical insufficiency-related mortality in the United States from 1999 to 2020

  • 期刊论文

  • 发表日期：

    2026年3月26日

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  • Ahmed Faizan,
  • Zain Shahzad,
  • Muhammad Sarosh Tahir,
  • Rabail Abdul Qadir,
  • Eeshal Fatima

摘要

Purpose

Adrenocortical insufficiency (AI), one of the most common hormonal deficiencies, is associated with significant mortality due to acute precipitation of adrenal crisis. This study aims to assess trends and disparities in mortality due to AI in the United States of America (US) from 1999 to 2020.

Methods

Death certificate data pertaining to AI-related mortality were retrieved from the CDC WONDER database. Crude mortality rates (CMRs) and age-adjusted mortality rates (AAMRs) were calculated per 1,000,000 population. Annual percentage change (APC) and average APC were used to assess temporal trends using Joinpoint regression.

Results

A total of 26,791 deaths occurred due to AI in the US from 1999 to 2020, with an increasing overall trend (average APC: 1.68). Males (5.89) had a higher AAMR than females (5.52). Non-Hispanic (NH) American Indians (9.62) had the highest AAMR and Hispanics (4.11) had the lowest. CMRs in older adults (19.81) aged 65 + years were ten times higher than those of young adults (2.37) aged 25–64 years. Rural areas (6.72) had higher mortality than urban areas (5.43). The Midwest (6.27) reported the highest mortality among the census regions, and the Northeast (4.91) the least. The states with the highest AAMRs were North Dakota (11.25) and Oklahoma (9.54), while Florida (3.32) and Nevada (2.99) had the lowest.

Conclusion

Adults in the US have shown increasing mortality burden due to AI, with men, NH American Indians, older adults and rural populations being the most high-risk. Targeted strategies need to be developed to curb the rise in mortality rates.