Nationwide analysis of adrenocortical carcinoma reveals higher perioperative morbidity in functional tumors

Current adrenalectomy outcomes for functional adrenocortical carcinoma (ACC) remain unclear. This study examines nationwide in-hospital post-adrenalectomy outcomes for ACC. A retrospective analysis of the Nationwide Inpatient Sample database (2006–2011) to identify unilateral adrenalectomy patients...

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Bibliographic Details
Published in:The American journal of surgery 2018-08, Vol.216 (2), p.293-298
Main Authors: Parikh, Punam P., Rubio, Gustavo A., Farra, Josefina C., Lew, John I.
Format: Article
Language:English
Subjects:
Adrenal Cortex Neoplasms - diagnosis
Adrenal Cortex Neoplasms - epidemiology
Adrenal Cortex Neoplasms - surgery
Adrenal glands
Adrenalectomy
Adrenalectomy - methods
Adrenocortical carcinoma
Adrenocortical Carcinoma - diagnosis
Adrenocortical Carcinoma - epidemiology
Adrenocortical Carcinoma - surgery
Blood transfusions
Clinical outcomes
Comorbidity
Complications
Cross-Sectional Studies
Demographics
Demography
Diabetes
Embolisms
Endocrine disorders
Female
Follow-Up Studies
Functional tumor
Heart failure
Hospitals
Humans
Hypertension
Liver diseases
Lung diseases
Male
Medicaid
Middle Aged
Morbidity
Morbidity - trends
Multivariate analysis
Neuroendocrine tumors
Obesity
Optimization
Patients
Population Surveillance
Postoperative Complications - epidemiology
Regression analysis
Retrospective Studies
Risk groups
Statistical tests
Survival Rate - trends
Tumors
United States - epidemiology
Variables
Wounds
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Description
Summary:Current adrenalectomy outcomes for functional adrenocortical carcinoma (ACC) remain unclear. This study examines nationwide in-hospital post-adrenalectomy outcomes for ACC. A retrospective analysis of the Nationwide Inpatient Sample database (2006–2011) to identify unilateral adrenalectomy patients for functional or nonfunctional ACC was performed. Patient demographics, comorbidities and postoperative outcomes were evaluated by t-test, Chi-square and multivariate regression. Of 2199 patients who underwent adrenalectomy, 87% had nonfunctional and 13% had functional ACC (86% hypercortisolism, 16% hyperaldosteronism, 4% hyperandrogenism). Functional ACC patients had significantly more comorbidities, and experienced certain postoperative complications more frequently including wound issues, adrenocortical insufficiency and acute kidney injury with longer hospital stay compared to nonfunctional ACC (P 
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2017.08.018