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

作者：Pasquier Ludwig; Kirouani Medhi; Fanget Florian; Nomine Claire; Caillard Cecile; Arnault Vincent; Finel Jean Baptiste; Christou Niki; Mathonnet Muriel; Tresallet Christophe; Hamy Antoine; de Calan Loic; Brunaud Laurent; Menegaux Fabrice; Lifante Jean Christophe; Hardouin Jean Benoit; Drui Delphine; Mirallie Eric; Blanchard Claire^*

来源：Langenbeck's Archives of Surgery, 2017, 402(2): 309-314.

DOI：10.1007/s00423-017-1557-x

• Aldosterone producing adenoma
• Adrenalectomy
• Hypertension
• Aldosteronoma resolution score

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/m(2), 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/m(2), 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.

• 出版日期2017-3