To evaluate the risk factors for postoperative vasopressor requirement among patients with pheochromocytoma undergoing retroperitoneal adrenalectomy. The primary outcome was postoperative hypotension requiring vasopressor support.
A single-center retrospective observational study.
Adults who underwent unilateral adrenalectomy for pheochromocytoma between October 2015 and February 2020.
Measurements and Main Results
Overall, 201 patients were included. Postoperative vasopressor requirement was observed in 39 (19.4%) patients and is associated with baseline coronary artery disease (CAD) [odds ratio (OR) 6.21, 95% confidence interval (CI) 2.48–15.52; p = 0.0001], maximal systolic blood pressure (maxSBP) >195 mmHg (OR 3.71, 95% CI 1.53–8.95; p = 0.0035), and >5.1-fold increase in the upper limit of normal values for baseline adrenergic activity (OR 4.9, 95% CI 1.93–12.55; p = 0.0008). The area under receiver operating characteristic curve of the predictive model was 0.804 (95% CI 0.742–0.856).
MaxSBP >195 mmHg, baseline adrenergic activity >5.1-fold increase in the upper limit of normal values, and baseline CAD could predict post-resection requirement for vasoactive support. Prospective multicenter international studies are required to develop and validate universally accepted predictive models for postoperative complications in patients after adrenalectomy for pheochromocytoma.
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