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Irish Journal of Medical Science (1971 -)

Erschienen in:

10.06.2024 | Original Article

Establishment of a scoring model for predicting clinical outcomes in patients with unilateral primary aldosteronism after superselective adrenal artery embolization

verfasst von: Tao Luo, Jindong Wan, Sen Liu, Xinquan Wang, Peng Zhou, Qiang Xue, Jixin Hou, Peijian Wang

Erschienen in: Irish Journal of Medical Science (1971 -) | Ausgabe 5/2024

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Abstract

Objective

Superselective adrenal arterial embolization (SAAE) is a potential alternative treatment for patients with unilateral primary aldosteronism (PA) who refuse unilateral adrenalectomy. Therefore, we aimed to establish a scoring model to differentiate between hypertensive remission after SAAE.

Methods

This prospective cohort study involved 240 patients who underwent SAAE for unilateral PA. Patients were randomly divided into a model training set and a validation set at a ratio of 7:3. The clinical outcome was a response to hypertension remission, defined as complete, partial, or absent success at 6 months after SAAE. Multivariate logistic regression was performed to identify independent parameters and develop a nomogram to predict clinical outcomes after SAAE. The discrimination, calibration efficacy, and clinical utility of the predictive model were assessed.

Results

Five independent predictors were identified: female sex, duration of hypertension, defined daily dose of antihypertensive medication, diabetes, and target organ damage. The above five independent predictors were put into a predictive model that was presented as a nomogram. Using bootstrapping for internal validation, the C-statistic for the predictive model was 0.866 (95% confidence interval [CI]: 0.834 to 0.898). In the validation cohort, the area under the curve (AUC) of the nomogram for predicting hypertension remission after SAAE was 0.809.

Conclusion

The present model is the first nomogram-based score that specifically predicts hypertension remission after SAAE in patients with unilateral PA using conventional parameters. This is an effective risk stratification tool that can be used by clinicians for timely and tailored preoperative risk discussions.

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Titel: Establishment of a scoring model for predicting clinical outcomes in patients with unilateral primary aldosteronism after superselective adrenal artery embolization
verfasst von: Tao Luo
Jindong Wan
Sen Liu
Xinquan Wang
Peng Zhou
Qiang Xue
Jixin Hou
Peijian Wang
Publikationsdatum: 10.06.2024
Verlag: Springer International Publishing
Erschienen in: Irish Journal of Medical Science (1971 -) / Ausgabe 5/2024
Print ISSN: 0021-1265
Elektronische ISSN: 1863-4362
DOI: https://doi.org/10.1007/s11845-024-03730-5

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Establishment of a scoring model for predicting clinical outcomes in patients with unilateral primary aldosteronism after superselective adrenal artery embolization