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The Therapeutic Intensity Score as Predictor of Clinical Outcomes after Total and Partial Adrenalectomy for Unilateral Primary Aldosteronism: Results of a Multicentric Series
Background: To evaluate the ability of therapeutic intensity score (TIS) in predicting the clinical outcomes of partial (PA) and total adrenalectomy (TA) for UPA. Methods: Between 2011 and 2022, a four-center adrenalectomy dataset was queried for “unilateral adrenal mass” and “UPA” (n = 90). Preoper...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9917842/ https://www.ncbi.nlm.nih.gov/pubmed/36769646 http://dx.doi.org/10.3390/jcm12030997 |
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author | Anceschi, Umberto Mormando, Marilda Flammia, Rocco Simone Fiori, Cristian Zappalà, Orazio De Concilio, Bernardino Brassetti, Aldo Carrara, Alessandro Ferriero, Maria Consiglia Tuderti, Gabriele Misuraca, Leonardo Prata, Francesco Tufano, Antonio Bove, Alfredo Maria Mastroianni, Riccardo Appetecchia, Marialuisa Tirone, Giuseppe Porpiglia, Francesco Celia, Antonio Simone, Giuseppe |
author_facet | Anceschi, Umberto Mormando, Marilda Flammia, Rocco Simone Fiori, Cristian Zappalà, Orazio De Concilio, Bernardino Brassetti, Aldo Carrara, Alessandro Ferriero, Maria Consiglia Tuderti, Gabriele Misuraca, Leonardo Prata, Francesco Tufano, Antonio Bove, Alfredo Maria Mastroianni, Riccardo Appetecchia, Marialuisa Tirone, Giuseppe Porpiglia, Francesco Celia, Antonio Simone, Giuseppe |
author_sort | Anceschi, Umberto |
collection | PubMed |
description | Background: To evaluate the ability of therapeutic intensity score (TIS) in predicting the clinical outcomes of partial (PA) and total adrenalectomy (TA) for UPA. Methods: Between 2011 and 2022, a four-center adrenalectomy dataset was queried for “unilateral adrenal mass” and “UPA” (n = 90). Preoperative TIS of each antihypertensive medication were individually calculated and merged to create a single, cumulative variable. Probability of complete clinical, partial, and absent pooled success rates according to TIS were assessed for the overall cohort by Kaplan–Meier. Cox analyses were used to identify predictors of complete clinical and partial/absent success, respectively. For all analyses, a two-sided p < 0.05 was considered significant. Results: At a median follow-up of 42 months (IQR 27–54) complete partial, and absent clinical success were observed in 60%, 17.7%, and 22.3%, respectively. On Kaplan–Meier analysis, TIS < 1 predicted higher complete success rates (p < 0.001), while TIS ≥ 1 was predictor of either partial and absent clinical success (p = 0.008). On multivariable analysis, TIS < 1 (HR 0.25; 95% CI 0.11–0.57; p = 0.001) and adenoma size (HR 1.11; 95% CI 1–1.23; p = 0.0049) were independent predictors of complete clinical success, while TIS ≥ 1 (HR 2.84; 95% CI 1.32–6.1; p = 0.007) was the only independent predictor of absent clinical success. Conclusions: TIS score and adenoma size may help to identify patients who are likely to be at risk of persistent hypertension after surgery. |
format | Online Article Text |
id | pubmed-9917842 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-99178422023-02-11 The Therapeutic Intensity Score as Predictor of Clinical Outcomes after Total and Partial Adrenalectomy for Unilateral Primary Aldosteronism: Results of a Multicentric Series Anceschi, Umberto Mormando, Marilda Flammia, Rocco Simone Fiori, Cristian Zappalà, Orazio De Concilio, Bernardino Brassetti, Aldo Carrara, Alessandro Ferriero, Maria Consiglia Tuderti, Gabriele Misuraca, Leonardo Prata, Francesco Tufano, Antonio Bove, Alfredo Maria Mastroianni, Riccardo Appetecchia, Marialuisa Tirone, Giuseppe Porpiglia, Francesco Celia, Antonio Simone, Giuseppe J Clin Med Article Background: To evaluate the ability of therapeutic intensity score (TIS) in predicting the clinical outcomes of partial (PA) and total adrenalectomy (TA) for UPA. Methods: Between 2011 and 2022, a four-center adrenalectomy dataset was queried for “unilateral adrenal mass” and “UPA” (n = 90). Preoperative TIS of each antihypertensive medication were individually calculated and merged to create a single, cumulative variable. Probability of complete clinical, partial, and absent pooled success rates according to TIS were assessed for the overall cohort by Kaplan–Meier. Cox analyses were used to identify predictors of complete clinical and partial/absent success, respectively. For all analyses, a two-sided p < 0.05 was considered significant. Results: At a median follow-up of 42 months (IQR 27–54) complete partial, and absent clinical success were observed in 60%, 17.7%, and 22.3%, respectively. On Kaplan–Meier analysis, TIS < 1 predicted higher complete success rates (p < 0.001), while TIS ≥ 1 was predictor of either partial and absent clinical success (p = 0.008). On multivariable analysis, TIS < 1 (HR 0.25; 95% CI 0.11–0.57; p = 0.001) and adenoma size (HR 1.11; 95% CI 1–1.23; p = 0.0049) were independent predictors of complete clinical success, while TIS ≥ 1 (HR 2.84; 95% CI 1.32–6.1; p = 0.007) was the only independent predictor of absent clinical success. Conclusions: TIS score and adenoma size may help to identify patients who are likely to be at risk of persistent hypertension after surgery. MDPI 2023-01-28 /pmc/articles/PMC9917842/ /pubmed/36769646 http://dx.doi.org/10.3390/jcm12030997 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Anceschi, Umberto Mormando, Marilda Flammia, Rocco Simone Fiori, Cristian Zappalà, Orazio De Concilio, Bernardino Brassetti, Aldo Carrara, Alessandro Ferriero, Maria Consiglia Tuderti, Gabriele Misuraca, Leonardo Prata, Francesco Tufano, Antonio Bove, Alfredo Maria Mastroianni, Riccardo Appetecchia, Marialuisa Tirone, Giuseppe Porpiglia, Francesco Celia, Antonio Simone, Giuseppe The Therapeutic Intensity Score as Predictor of Clinical Outcomes after Total and Partial Adrenalectomy for Unilateral Primary Aldosteronism: Results of a Multicentric Series |
title | The Therapeutic Intensity Score as Predictor of Clinical Outcomes after Total and Partial Adrenalectomy for Unilateral Primary Aldosteronism: Results of a Multicentric Series |
title_full | The Therapeutic Intensity Score as Predictor of Clinical Outcomes after Total and Partial Adrenalectomy for Unilateral Primary Aldosteronism: Results of a Multicentric Series |
title_fullStr | The Therapeutic Intensity Score as Predictor of Clinical Outcomes after Total and Partial Adrenalectomy for Unilateral Primary Aldosteronism: Results of a Multicentric Series |
title_full_unstemmed | The Therapeutic Intensity Score as Predictor of Clinical Outcomes after Total and Partial Adrenalectomy for Unilateral Primary Aldosteronism: Results of a Multicentric Series |
title_short | The Therapeutic Intensity Score as Predictor of Clinical Outcomes after Total and Partial Adrenalectomy for Unilateral Primary Aldosteronism: Results of a Multicentric Series |
title_sort | therapeutic intensity score as predictor of clinical outcomes after total and partial adrenalectomy for unilateral primary aldosteronism: results of a multicentric series |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9917842/ https://www.ncbi.nlm.nih.gov/pubmed/36769646 http://dx.doi.org/10.3390/jcm12030997 |
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