Assessment of the Aldosteronona resolution score as a predictive resolution score of hypertension after adrenalectomy for aldosteronoma in French patients

• Published in: Langenbeck's archives of surgery 2017-03, Vol.402 (2), p.309-314
• Main Authors: Pasquier, Ludwig, Kirouani, Medhi, Fanget, Florian, Nomine, Claire, Caillard, Cécile, Arnault, Vincent, Finel, Jean-Baptiste, Christou, Niki, Mathonnet, Muriel, Trésallet, Christophe, Hamy, Antoine, de Calan, Loïc, Brunaud, Laurent, Menegaux, Fabrice, Lifante, Jean Christophe, Hardouin, Jean Benoit, Drui, Delphine, Mirallié, Éric, Blanchard, Claire
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Adenoma - blood; Adenoma - complications; Adenoma - surgery; Adolescent; Adrenal Gland Neoplasms - blood; Adrenal Gland Neoplasms - complications; Adrenal Gland Neoplasms - surgery; Adrenalectomy; Adult; Aged; Aged, 80 and over; Aldosterone - blood; Cardiac Surgery; Female; France; General Surgery; Humans; Hyperaldosteronism - complications; Hyperaldosteronism - diagnosis; Hyperaldosteronism - surgery; Hypertension - blood; Hypertension - complications; Hypertension - diagnosis; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Predictive Value of Tests; Retrospective Studies; Thoracic Surgery; Tomography, X-Ray Computed; Traumatic Surgery; Treatment Outcome; Vascular Surgery; Young Adult
• ISSN: 1435-2443; 1435-2451
• DOI: 10.1007/s00423-017-1557-x

Purpose Aldosteronoma Resolution Score (ARS) is a predictive score for cure of hypertension after adrenalectomy for hyperaldosteronism and has been validated in American patients. The aim of the study was to validate this score in a French population. Method Data concerning patients operated from 2002 to 2015 in 7 French University Hospitals were retrospectively collected. Diagnosis of Aldosterone-producing adenoma (APA) was confirmed with clinical and biochemical hyperaldosteronism and adrenal nodule on CT scan. Adrenal venous sampling was performed when CT failed to identify laterality. ARS is based on four variables: female sex, BMI ≤25 kg/m 2 , duration of hypertension ≤6 years, number of antihypertensive medications ≤2. One point is attributed for the first three and 2 points for the last. Patients were considered as cured if they had no hypertension and no antihypertensive medications at least 6 months after surgery. Patients with bilateral adrenal hyperplasia were excluded. Results This multicenter study included 310 patients with APA. ARS and follow-up were obtained in 257 patients. 46.6% of patients were cured and potassium serum level was normalized in 97.7%. In multivariate analysis, odds ratio for female sex, BMI ≤25 kg/m 2 , duration of hypertension ≤6 years, and number of antihypertensive medications ≤2 were 1.60 ( p  = 0.09), 1.77 ( p  = 0.04), 1.28 ( p  = 0.4), 3.41 ( p