A simplified primary aldosteronism surgical outcome score is a useful prediction model when target organ damage is unknown – Retrospective cohort study

Diederik P.D. Suurd; Wouter P. Visscher; Wessel M.C.M. Vorselaars; Dirk Jan van Beek; Wilko Spiering; Inne H.M. Borel Rinkes; Gerlof D. Valk; Menno R. Vriens; Rasa Zarnegar; Thomas J. Fahey; Quan Y. Duh; Wen T. Shen; Frederick T. Drake; David B. McAneny; Catherine McManus; James A. Lee; Scott B. Grant; Raymon H. Grogan; Minerva A. Romero Arenas; Nancy D. Perrier; Cord Sturgeon; Tanya Castelino; Elliot J. Mitmaker; David N. Parente; Jesse D. Pasternak; Stan B. Sidhu; Mark Sywak; Gerardo D'Amato; Marco Raffaelli; Valerie Schuermans; Nicole D. Bouvy; Hasan H. Eker; H. Jaap Bonjer; Anton F. Engelsman; Els J.M.Nieveen van Dijkum; Michiel N. Kerstens; Schelto Kruijff; International CONNsortium study group

doi:10.1016/j.amsu.2021.102333

A simplified primary aldosteronism surgical outcome score is a useful prediction model when target organ damage is unknown – Retrospective cohort study

Diederik P.D. Suurd, Wouter P. Visscher, Wessel M.C.M. Vorselaars, Dirk Jan van Beek, Wilko Spiering, Inne H.M. Borel Rinkes, Gerlof D. Valk, Menno R. Vriens^*, Rasa Zarnegar, Thomas J. Fahey, Quan Y. Duh, Wen T. Shen, Frederick T. Drake, David B. McAneny, Catherine McManus, James A. Lee, Scott B. Grant, Raymon H. Grogan, Minerva A. Romero Arenas, Nancy D. PerrierCord Sturgeon, Tanya Castelino, Elliot J. Mitmaker, David N. Parente, Jesse D. Pasternak, Stan B. Sidhu, Mark Sywak, Gerardo D'Amato, Marco Raffaelli, Valerie Schuermans, Nicole D. Bouvy, Hasan H. Eker, H. Jaap Bonjer, Anton F. Engelsman, Els J.M.Nieveen van Dijkum, Michiel N. Kerstens, Schelto Kruijff, International CONNsortium study group

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background: Cure of hypertension after adrenalectomy for primary aldosteronism is no certainty and therefore preoperative patient counseling is essential. The Primary Aldosteronism Surgical Outcome (PASO) Score is a useful prediction model with an area under the curve (AUC) of 0.839. The PASO Score includes ‘Target Organ Damage’ (TOD) (i.e., left ventricular hypertrophy and/or microalbuminuria), which is often unavailable during preoperative counseling and might therefore limit its use in clinical practice. We hypothesized that the PASO score would still be useful if TOD is unknown at time of counseling. Therefore, we aimed to examine the predictive performance of the simplified PASO Score, without taking TOD into account. Materials and methods: In this retrospective cohort study, patients who underwent unilateral adrenalectomy between 2010 and 2016 in 16 medical centers from North America, Europe and Australia were included. TOD was unknown in our database and therefore assigned as absent. Patients were classified as complete, partial or absent clinical success using the PASO consensus criteria. Results: A total of 380 (73.9%) patients were eligible for analysis. Complete, partial and absent clinical success were observed in 29.5%, 55.8% and 14.7% of patients, respectively. The simplified PASO Score had an AUC of 0.730 (95% confidence interval 0.674–0.785) in our total cohort. Conclusion: Without taking TOD into account, the simplified PASO Score had a lower predictive value as compared to the original derivation cohort. Ideally, the complete PASO Score should be used, but when data on TOD are not readily available, the simplified PASO Score is a useful and reasonable alternative.

Original language	English
Article number	102333
Number of pages	6
Journal	Annals of Medicine and Surgery
Volume	65
DOIs	https://doi.org/10.1016/j.amsu.2021.102333
Publication status	Published - 1 May 2021

Keywords

Adrenalectomy
Blood pressure
Endocrine surgery
Hypertension
PASO score
Primary aldosteronism

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Suurd, D. P. D., Visscher, W. P., Vorselaars, W. M. C. M., van Beek, D. J., Spiering, W., Borel Rinkes, I. H. M., Valk, G. D., Vriens, M. R., Zarnegar, R., Fahey, T. J., Duh, Q. Y., Shen, W. T., Drake, F. T., McAneny, D. B., McManus, C., Lee, J. A., Grant, S. B., Grogan, R. H., Romero Arenas, M. A., ... International CONNsortium study group (2021). A simplified primary aldosteronism surgical outcome score is a useful prediction model when target organ damage is unknown – Retrospective cohort study. Annals of Medicine and Surgery, 65, Article 102333. https://doi.org/10.1016/j.amsu.2021.102333

@article{06d5edf7003243809e9d6f34ca979119,

title = "A simplified primary aldosteronism surgical outcome score is a useful prediction model when target organ damage is unknown – Retrospective cohort study",

abstract = "Background: Cure of hypertension after adrenalectomy for primary aldosteronism is no certainty and therefore preoperative patient counseling is essential. The Primary Aldosteronism Surgical Outcome (PASO) Score is a useful prediction model with an area under the curve (AUC) of 0.839. The PASO Score includes {\textquoteleft}Target Organ Damage{\textquoteright} (TOD) (i.e., left ventricular hypertrophy and/or microalbuminuria), which is often unavailable during preoperative counseling and might therefore limit its use in clinical practice. We hypothesized that the PASO score would still be useful if TOD is unknown at time of counseling. Therefore, we aimed to examine the predictive performance of the simplified PASO Score, without taking TOD into account. Materials and methods: In this retrospective cohort study, patients who underwent unilateral adrenalectomy between 2010 and 2016 in 16 medical centers from North America, Europe and Australia were included. TOD was unknown in our database and therefore assigned as absent. Patients were classified as complete, partial or absent clinical success using the PASO consensus criteria. Results: A total of 380 (73.9%) patients were eligible for analysis. Complete, partial and absent clinical success were observed in 29.5%, 55.8% and 14.7% of patients, respectively. The simplified PASO Score had an AUC of 0.730 (95% confidence interval 0.674–0.785) in our total cohort. Conclusion: Without taking TOD into account, the simplified PASO Score had a lower predictive value as compared to the original derivation cohort. Ideally, the complete PASO Score should be used, but when data on TOD are not readily available, the simplified PASO Score is a useful and reasonable alternative.",

keywords = "Adrenalectomy, Blood pressure, Endocrine surgery, Hypertension, PASO score, Primary aldosteronism",

author = "Suurd, {Diederik P.D.} and Visscher, {Wouter P.} and Vorselaars, {Wessel M.C.M.} and {van Beek}, {Dirk Jan} and Wilko Spiering and {Borel Rinkes}, {Inne H.M.} and Valk, {Gerlof D.} and Vriens, {Menno R.} and Rasa Zarnegar and Fahey, {Thomas J.} and Duh, {Quan Y.} and Shen, {Wen T.} and Drake, {Frederick T.} and McAneny, {David B.} and Catherine McManus and Lee, {James A.} and Grant, {Scott B.} and Grogan, {Raymon H.} and {Romero Arenas}, {Minerva A.} and Perrier, {Nancy D.} and Cord Sturgeon and Tanya Castelino and Mitmaker, {Elliot J.} and Parente, {David N.} and Pasternak, {Jesse D.} and Sidhu, {Stan B.} and Mark Sywak and Gerardo D'Amato and Marco Raffaelli and Valerie Schuermans and Bouvy, {Nicole D.} and Eker, {Hasan H.} and Bonjer, {H. Jaap} and Engelsman, {Anton F.} and {van Dijkum}, {Els J.M.Nieveen} and Kerstens, {Michiel N.} and Schelto Kruijff and {International CONNsortium study group}",

note = "Publisher Copyright: {\textcopyright} 2021 The Author(s)",

year = "2021",

month = may,

day = "1",

doi = "10.1016/j.amsu.2021.102333",

language = "English",

volume = "65",

journal = "Annals of Medicine and Surgery",

issn = "2049-0801",

publisher = "ELSEVIER SCI LTD",

}

Suurd, DPD, Visscher, WP, Vorselaars, WMCM, van Beek, DJ, Spiering, W, Borel Rinkes, IHM, Valk, GD, Vriens, MR, Zarnegar, R, Fahey, TJ, Duh, QY, Shen, WT, Drake, FT, McAneny, DB, McManus, C, Lee, JA, Grant, SB, Grogan, RH, Romero Arenas, MA, Perrier, ND, Sturgeon, C, Castelino, T, Mitmaker, EJ, Parente, DN, Pasternak, JD, Sidhu, SB, Sywak, M, D'Amato, G, Raffaelli, M, Schuermans, V , Bouvy, ND, Eker, HH, Bonjer, HJ, Engelsman, AF, van Dijkum, EJMN, Kerstens, MN, Kruijff, S & International CONNsortium study group 2021, 'A simplified primary aldosteronism surgical outcome score is a useful prediction model when target organ damage is unknown – Retrospective cohort study', Annals of Medicine and Surgery, vol. 65, 102333. https://doi.org/10.1016/j.amsu.2021.102333

A simplified primary aldosteronism surgical outcome score is a useful prediction model when target organ damage is unknown – Retrospective cohort study. / Suurd, Diederik P.D.; Visscher, Wouter P.; Vorselaars, Wessel M.C.M. et al.
In: Annals of Medicine and Surgery, Vol. 65, 102333, 01.05.2021.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - A simplified primary aldosteronism surgical outcome score is a useful prediction model when target organ damage is unknown – Retrospective cohort study

AU - Suurd, Diederik P.D.

AU - Visscher, Wouter P.

AU - Vorselaars, Wessel M.C.M.

AU - van Beek, Dirk Jan

AU - Spiering, Wilko

AU - Borel Rinkes, Inne H.M.

AU - Valk, Gerlof D.

AU - Vriens, Menno R.

AU - Zarnegar, Rasa

AU - Fahey, Thomas J.

AU - Duh, Quan Y.

AU - Shen, Wen T.

AU - Drake, Frederick T.

AU - McAneny, David B.

AU - McManus, Catherine

AU - Lee, James A.

AU - Grant, Scott B.

AU - Grogan, Raymon H.

AU - Romero Arenas, Minerva A.

AU - Perrier, Nancy D.

AU - Sturgeon, Cord

AU - Castelino, Tanya

AU - Mitmaker, Elliot J.

AU - Parente, David N.

AU - Pasternak, Jesse D.

AU - Sidhu, Stan B.

AU - Sywak, Mark

AU - D'Amato, Gerardo

AU - Raffaelli, Marco

AU - Schuermans, Valerie

AU - Bouvy, Nicole D.

AU - Eker, Hasan H.

AU - Bonjer, H. Jaap

AU - Engelsman, Anton F.

AU - van Dijkum, Els J.M.Nieveen

AU - Kerstens, Michiel N.

AU - Kruijff, Schelto

AU - International CONNsortium study group

PY - 2021/5/1

Y1 - 2021/5/1

N2 - Background: Cure of hypertension after adrenalectomy for primary aldosteronism is no certainty and therefore preoperative patient counseling is essential. The Primary Aldosteronism Surgical Outcome (PASO) Score is a useful prediction model with an area under the curve (AUC) of 0.839. The PASO Score includes ‘Target Organ Damage’ (TOD) (i.e., left ventricular hypertrophy and/or microalbuminuria), which is often unavailable during preoperative counseling and might therefore limit its use in clinical practice. We hypothesized that the PASO score would still be useful if TOD is unknown at time of counseling. Therefore, we aimed to examine the predictive performance of the simplified PASO Score, without taking TOD into account. Materials and methods: In this retrospective cohort study, patients who underwent unilateral adrenalectomy between 2010 and 2016 in 16 medical centers from North America, Europe and Australia were included. TOD was unknown in our database and therefore assigned as absent. Patients were classified as complete, partial or absent clinical success using the PASO consensus criteria. Results: A total of 380 (73.9%) patients were eligible for analysis. Complete, partial and absent clinical success were observed in 29.5%, 55.8% and 14.7% of patients, respectively. The simplified PASO Score had an AUC of 0.730 (95% confidence interval 0.674–0.785) in our total cohort. Conclusion: Without taking TOD into account, the simplified PASO Score had a lower predictive value as compared to the original derivation cohort. Ideally, the complete PASO Score should be used, but when data on TOD are not readily available, the simplified PASO Score is a useful and reasonable alternative.

AB - Background: Cure of hypertension after adrenalectomy for primary aldosteronism is no certainty and therefore preoperative patient counseling is essential. The Primary Aldosteronism Surgical Outcome (PASO) Score is a useful prediction model with an area under the curve (AUC) of 0.839. The PASO Score includes ‘Target Organ Damage’ (TOD) (i.e., left ventricular hypertrophy and/or microalbuminuria), which is often unavailable during preoperative counseling and might therefore limit its use in clinical practice. We hypothesized that the PASO score would still be useful if TOD is unknown at time of counseling. Therefore, we aimed to examine the predictive performance of the simplified PASO Score, without taking TOD into account. Materials and methods: In this retrospective cohort study, patients who underwent unilateral adrenalectomy between 2010 and 2016 in 16 medical centers from North America, Europe and Australia were included. TOD was unknown in our database and therefore assigned as absent. Patients were classified as complete, partial or absent clinical success using the PASO consensus criteria. Results: A total of 380 (73.9%) patients were eligible for analysis. Complete, partial and absent clinical success were observed in 29.5%, 55.8% and 14.7% of patients, respectively. The simplified PASO Score had an AUC of 0.730 (95% confidence interval 0.674–0.785) in our total cohort. Conclusion: Without taking TOD into account, the simplified PASO Score had a lower predictive value as compared to the original derivation cohort. Ideally, the complete PASO Score should be used, but when data on TOD are not readily available, the simplified PASO Score is a useful and reasonable alternative.

KW - Adrenalectomy

KW - Blood pressure

KW - Endocrine surgery

KW - Hypertension

KW - PASO score

KW - Primary aldosteronism

U2 - 10.1016/j.amsu.2021.102333

DO - 10.1016/j.amsu.2021.102333

M3 - Article

SN - 2049-0801

VL - 65

JO - Annals of Medicine and Surgery

JF - Annals of Medicine and Surgery

M1 - 102333

ER -

A simplified primary aldosteronism surgical outcome score is a useful prediction model when target organ damage is unknown – Retrospective cohort study

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Keywords

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