Validation of the Aldosteronoma Resolution Score as a Predictive Resolution Score of Hypertension After Unilateral Adrenalectomy for Primary Aldosteronism in a North-African Population

Background Unilateral primary aldosteronism (UPA) is the most frequent surgically curable form of endocrine hypertension. Adrenalectomy is the cornerstone of treatment for UPA, but outcomes after surgery are variable. Aldosteronoma Resolution Score (ARS) is a four-item predictive score for the cure...

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Published in:World journal of surgery 2023-11, Vol.47 (11), p.2776-2783
Main Authors: Saadi, Ahmed, Bedoui, Mohamed Ali, Zaghbib, Selim, Boussaffa, Hamza, Mokaddem, Seif, Nacef, Ibtissem Ben, Ayed, Haroun, Bouzouita, Abderrazek, Derouiche, Amine, Khiari, Karima, Chakroun, Marouene, Slama, Riadh Ben
Format: Article
Language:English
Subjects:
Abdominal Surgery
Adrenalectomy
Antihypertensives
Cardiac Surgery
Diabetes mellitus
Endocrine disorders
General Surgery
Hypertension
Laparoscopy
Medicine
Medicine & Public Health
Original Scientific Report
Patients
Populations
Regression analysis
Surgery
Thoracic Surgery
Vascular Surgery
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Summary:Background Unilateral primary aldosteronism (UPA) is the most frequent surgically curable form of endocrine hypertension. Adrenalectomy is the cornerstone of treatment for UPA, but outcomes after surgery are variable. Aldosteronoma Resolution Score (ARS) is a four-item predictive score for the cure of hypertension after adrenalectomy for UPA and has been demonstrated to be valid in different populations. We aimed in this study to validate the accuracy of this score in a North-African population. Methods Between 2000 and 2021, the charts of 71 Tunisian patients who underwent laparoscopic adrenalectomy for UPA were retrospectively reviewed. Postoperative outcomes were assessed using the primary aldosteronism surgical outcome (PASO) criterion. The accuracy of the ARS was determined retrospectively by receiver operating characteristic curve and area under the curve. Results Thirty-four patients (48%) had complete clinical success according to the PASO criteria. Multivariate regression analysis revealed that the main determinants of complete clinical success were the absence of diabetes (OR: 5.205), a BMI 332 (OR: 4.554) and an ARS score ≥3 (OR: 2.056). Cure rates were, respectively, 21.1, 51.6, and 66.6% for patients with a score ARS 0–1, 2–3, and 4–5. The AUC of the ARS was 0.837. Conclusion The ARS is a sufficiently predictive score in our North-African population. It may be used preoperatively to predict the outcome after adrenalectomy in these populations.
ISSN:0364-2313
1432-2323
1432-2323
DOI:10.1007/s00268-023-07155-6