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Whether this has an impact on overall mortality, however, is still unclear.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>PubMed\/Medline, EMBASE, and Cochrane Library databases were systematically searched until May 2023 for studies reporting data either about standardized mortality ratios (SMRs) or about predictors of mortality in patients with NFPA. Effect sizes were pooled through a random-effect model. This systematic review and meta-analysis was registered in the International Prospective Register of Systematic Reviews (PROSPERO, #CRD42023417782).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Eleven studies were eligible for inclusion in the systematic review; among these, five studies reported data on SMRs, with a total follow-up time of approximately 130,000 person-years. Patients with NFPA showed an increased mortality risk compared to the general population (SMR\u2009=\u20091.57 [95%CI: 1.20\u20131.99], p\u2009&lt;\u20090.01). Age and sex appeared to act as effect modifiers, with a trend towards higher SMRs in females (SMR\u2009=\u20091.57 [95%CI: 0.91\u20132.41], p\u2009=\u20090.10) than in males (SMR\u2009=\u20091.00 [95%CI: 0.89\u20131.11], p\u2009=\u20090.97), and in patients diagnosed at age 40\u00a0years or younger (SMR\u2009=\u20093.19 [95%CI: 2.50\u20133.97], p\u2009&lt;\u20090.01) compared to those with later onset of the disease (SMR\u2009=\u20091.26 [95%CI: 0.93\u20131.65], p\u2009=\u20090.13). The trend towards excess mortality was similar in patients with normal (SMR\u2009=\u20091.22 [95%CI: 0.94\u20131.53], p\u2009=\u20090.13) or deficient (SMR\u2009=\u20091.26 [95%CI: 0.82\u20131.79], p\u2009=\u20090.27) pituitary function.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Excess mortality is observed in patients with NFPA, regardless of pituitary function, especially in women and in patients with a younger age at diagnosis.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s40618-024-02356-9","type":"journal-article","created":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T19:02:47Z","timestamp":1710874967000},"page":"2143-2155","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Excess mortality in patients with non-functioning pituitary adenoma: a systematic review and meta-analysis"],"prefix":"10.1007","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7550-7023","authenticated-orcid":false,"given":"F.","family":"Bioletto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Sibilla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Gasco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Ghigo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Grottoli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,3,19]]},"reference":[{"key":"2356_CR1","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1007\/s12022-022-09703-7","volume":"33","author":"SL Asa","year":"2022","unstructured":"Asa SL, Mete O, Perry A, Osamura RY (2022) Overview of the 2022 who classification of pituitary tumors. 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