Mortality Risk and Causes of Death in Exogenous Cushing’s Syndrome: A Systematic Review and Meta-analysis

Chronic oral GC exposure was associated with increased mortality across disease groups, with higher cumulative and early-treatment doses correlating with higher risk. However, causal attribution remains uncertain due to confounding by indication, limited disease-severity data, and exposure misclassification. These findings support glucocorticoid stewardship and targeted cardiovascular and infection risk mitigation, rather than indiscriminate dose reduction.