Validation of the Aldosteronoma Resolution Score Within Current Clinical Practice

Area of Science:

• Endocrinology
• Surgical Oncology
• Hypertension Management

Background:

• Primary aldosteronism treatment often involves adrenalectomy, but hypertension resolution is not guaranteed.
• Preoperative patient counseling is crucial due to variable outcomes.
• The Aldosteronoma Resolution Score (ARS) is a simple prediction model for hypertension resolution post-adrenalectomy.

Purpose of the Study:

• To validate the Aldosteronoma Resolution Score (ARS) in an international cohort.
• To assess the ARS's applicability in current clinical practice outside the USA.
• To evaluate the predictive performance of the ARS in diverse geographic regions.

Main Methods:

• An international cohort of 435 patients undergoing unilateral adrenalectomy between 2010-2016 was analyzed.
• Data were collected from 16 medical centers across the USA, Europe, Canada, and Australia.
• Hypertension resolution was defined as normotension without antihypertensive medication.

Main Results:

• Overall hypertension resolution was achieved in 27% of patients.
• Resolution rates varied by region: USA (22%), Europe (30%), Canada (40%), Australia (38%).
• The Aldosteronoma Resolution Score (ARS) demonstrated an Area Under the Curve (AUC) of 0.751 for the total cohort, with regional AUCs ranging from 0.667 to 0.811.

Conclusions:

• The ARS is a practical prediction tool with moderate to good performance in current clinical practice.
• The model's predictive accuracy is highest in North America (USA and Canada).
• The ARS may have reduced predictive performance in European and Australian cohorts.