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01-05-2021 | Adrenalectomy | Original Scientific Report

Outcomes of Adrenalectomy and the Aldosteronoma Resolution Score in the Black and Hispanic Population

Authors: Gustavo Romero‐Velez, Amanda M. Laird, Manuel E. Barajas, Mauricio Sierra-Salazar, Miguel F. Herrera, Steven K. Libutti, Michael K. Parides, Xavier Pereira, John C. McAuliffe

Published in: World Journal of Surgery | Issue 5/2021

Abstract

Background

Outcomes after adrenalectomy in patients with primary aldosteronism (PA) are variable. The aldosteronoma resolution score (ARS) uses preoperative variables to calculate a score that identifies those patients that are more likely to have resolution of hypertension after adrenalectomy. We aim to determine the efficacy of adrenalectomy and whether the ARS accurately predicts clinical success in a Black and Hispanic population.

Methods

We reviewed patients who underwent adrenalectomy for PA from 2004 to 2018 at two academic centers treating primarily Hispanic and Black patients. Postoperative outcomes were evaluated based on the primary aldosteronism surgical outcome consensus criterion. Retrospectively, the accuracy of ARS was determined by a receiver operating characteristic curve and the area under the curve (AUC).

Results

Forty-three Hispanic and 10 Black patients underwent adrenalectomy for PA. Twenty-two patients (41.5%) had complete clinical success. Variables associated with complete clinical success in the univariate analysis were female gender (p = 0.026), younger age (p = 0.001), lower preoperative aldosterone (p = 0.035), lower preoperative systolic blood pressure (p = 0.001), fewer number of preoperative antihypertensive medications (p = 0.007) and a higher ARS (p = 0.003). On multivariate analysis, only fewer number of preoperative antihypertensive medications was independently associated with complete clinical success (p = 0.026). The AUC of the ARS was 0.746.

Conclusion

The rate of clinical success from adrenalectomy is good for Hispanic and Black patients with PA. Our analysis shows that the ARS is an accurate test of clinical success in Hispanic and Black patients. The ARS may be utilized preoperatively to frame expectations after adrenalectomy in these populations.

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Title: Outcomes of Adrenalectomy and the Aldosteronoma Resolution Score in the Black and Hispanic Population
Authors: Gustavo Romero‐Velez
Amanda M. Laird
Manuel E. Barajas
Mauricio Sierra-Salazar
Miguel F. Herrera
Steven K. Libutti
Michael K. Parides
Xavier Pereira
John C. McAuliffe
Publication date: 01-05-2021
Publisher: Springer International Publishing
Keywords: Adrenalectomy
Hypertension
Adrenalectomy
Hypertension
Published in: World Journal of Surgery / Issue 5/2021
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-021-05967-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Outcomes of Adrenalectomy and the Aldosteronoma Resolution Score in the Black and Hispanic Population

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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