Abstract
Objectives
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.
Design
A single-center retrospective observational study.
Setting
University hospital.
Participants
Adults who underwent unilateral adrenalectomy for pheochromocytoma between October
2015 and February 2020.
Interventions
None.
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).
Conclusion
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.
Graphical Abstract
Graphical Abstract
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Article info
Publication history
Publication stage
In Press Accepted ManuscriptIdentification
Copyright
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