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

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Abstract

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 <30 (OR: 4.930), a number of antihypertensive medications ≤2 (OR: 8.667), a plasma ARR >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.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

We are grateful to all the Urology and Endocrinology Department staff of Charles Nicolle Hospital who contributed to this project.

Funding

No financial funding was used in this work.

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Authors and Affiliations

  1. Department of Urology, Charles Nicolle Hospital, University of Medicine of Tunis, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia

    Ahmed Saadi, Mohamed Ali Bedoui, Selim Zaghbib, Hamza Boussaffa, Seif Mokaddem, Haroun Ayed, Abderrazek Bouzouita, Amine Derouiche, Marouene Chakroun & Riadh Ben Slama

  2. Department of Endocrinology, Charles Nicolle Hospital, University of Medicine of Tunis, Tunis, Tunisia

    Ibtissem Ben Nacef & Karima Khiari

Authors
  1. Ahmed Saadi
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  2. Mohamed Ali Bedoui
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  3. Selim Zaghbib
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  4. Hamza Boussaffa
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Contributions

Study conception and Design: Ahmed Saadi, Mohamed Ali Bedoui, and Ibtissem Ben Nacef. Acquisition of data: Ahmed Saadi, Mohamed Ali Bedoui, Selim Zaghbib, Ibtissem Ben Nacef, Hamza Boussaffa, and Seif Mokadem. Analysis and interpretation of data: Ahmed Saadi, Mohamed Ali Bedoui, Selim Zaghbib, and Ibtissem Ben Nacef. Drafting of the manuscript: Ahmed Saadi and Mohamed Ali Bedoui. Critical revision of the manuscript: Ahmed Saadi, Ibtissem Ben Nacef, Abderrazek Bouzouita, Amine Derouiche, Karima Khiari Marouene Chakroun, and Riadh Ben Slama. Administrative support: Haroun Ayed, Abderrazek Bouzouita, Amine Derouiche, Karima Khiari, Marouene Chakroun, and Riadh Ben Slama. Final approval of manuscript: All Authors.

Corresponding author

Correspondence to Mohamed Ali Bedoui.

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Ethical approval is not required for this study in accordance with local and national guidelines. Written informed consent was obtained from the patient for publication of the details of their medical case.

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Saadi, A., Bedoui, M.A., Zaghbib, S. et al. Validation of the Aldosteronoma Resolution Score as a Predictive Resolution Score of Hypertension After Unilateral Adrenalectomy for Primary Aldosteronism in a North-African Population. World J Surg 47, 2776–2783 (2023). https://doi.org/10.1007/s00268-023-07155-6

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  • DOI: https://doi.org/10.1007/s00268-023-07155-6

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