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

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Abstract

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/m2, 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/m2, 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 < 0.001), respectively. Cure rate were, respectively, 22.2, 41.4 and 74% for patients with a score ARS 0–1, 2–3, 4–5. The area under the curve (AUC) of ARS was 0.715.

Conclusion

ARS is not a predictive score efficient enough in a French population maybe due to different metabolic data and genetic conditions.

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Acknowledgments

The authors thank endocrinologists in each university hospital who take part in the study.

Author’s contributions

Ludwig Pasquier: writing of manuscript, acquisition of data; Christophe Tresallet: acquisition of data; Medhi Kirouani: acquisition of data; Florian Fanget: acquisition of data; Vincent Arnault: acquisition of data; Jean-Baptiste Finel: acquisition of data; Niki Christou: acquisition of data; Muriel Mathonnet: acquisition of data; Cécile Caillard: acquisition of data; Claire Nomine: acquisition of data; Antoine Hamy: acquisition of data; Loïc de Calan: acquisition of data; Laurent Brunaud: acquisition of data; Jean Christophe Lifante: acquisition of data; Fabrice Menegaux: acquisition of data; Jean-Benoit Hardouin: analysis and interpretation of data; Delphine Drui: acquisition and interpretation of data; Eric Mirallie: study conception and design, critical revision of manuscript; Claire Blanchard: study conception and design, critical revision of manuscript.

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Authors and Affiliations

  1. Clinique de Chirurgie Digestive et Endocrinienne (CCDE), Institut des Maladies de l’Appareil Digestif (IMAD), CHU Hôtel-Dieu, 1 place Alexis Ricordeau, 44093, Nantes cedex 1, France

    Ludwig Pasquier, Cécile Caillard, Éric Mirallié & Claire Blanchard

  2. Service de chirurgie Générale, Viscérale et Endocrinienne, Hôpital Universitaire Pitié Salpêtrière, Paris, France

    Medhi Kirouani, Christophe Trésallet & Fabrice Menegaux

  3. Service de Chirurgie Endocrinienne et Générale, Centre Hospitalier Lyon Sud, Lyon, France

    Florian Fanget & Jean Christophe Lifante

  4. Service de Chirurgie Digestive, Hépatobiliaire, Pancréatique, Endocrinienne et Cancérologique, CHRU de Nancy, Nancy, France

    Claire Nomine & Laurent Brunaud

  5. Service de Chirurgie Digestive Endocrinienne et Transplantation Hépatique, CHRU de Tours, Tours, France

    Vincent Arnault & Loïc de Calan

  6. Service de Chirurgie Viscérale et Endocrinienne, CHU d’Angers, Angers, France

    Jean-Baptiste Finel & Antoine Hamy

  7. Service de Chirurgie Digestive, Générale et Endocrinienne, CHU Limoges, Limoges, France

    Niki Christou & Muriel Mathonnet

  8. Biomathematiques, Biostatistiques et Informatique, Faculté de Médecine, Université de Nantes, Nantes, France

    Jean Benoit Hardouin

  9. Service d’Endocrinologie, CHU Nantes, Nantes, France

    Delphine Drui

Authors
  1. Ludwig Pasquier
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  2. Medhi Kirouani
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  3. Florian Fanget
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  4. Claire Nomine
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  6. Vincent Arnault
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  7. Jean-Baptiste Finel
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  10. Christophe Trésallet
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  11. Antoine Hamy
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  12. Loïc de Calan
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  13. Laurent Brunaud
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  14. Fabrice Menegaux
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  15. Jean Christophe Lifante
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  16. Jean Benoit Hardouin
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  17. Delphine Drui
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  18. Éric Mirallié
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  19. Claire Blanchard
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Corresponding author

Correspondence to Claire Blanchard.

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Pasquier, L., Kirouani, M., Fanget, F. et al. Assessment of the Aldosteronona resolution score as a predictive resolution score of hypertension after adrenalectomy for aldosteronoma in French patients. Langenbecks Arch Surg 402, 309–314 (2017). https://doi.org/10.1007/s00423-017-1557-x

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  • DOI: https://doi.org/10.1007/s00423-017-1557-x

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