Prediction of postoperative hypoglycemia in patients with pheochromocytoma resection: a retrospective study

Hypoglycemia after pheochromocytoma resection is one of the most common complications. The factors predicting postoperative hypoglycemia are not well established. The objective of this study was to develop a model to predict hypoglycemia in patients after pheochromocytoma resection.

This single-center retrospective study enrolled adult patients who underwent pheochromocytoma resection between September 2019 and August 2025. Logistic regression identified risk factors for postoperative hypoglycemia, based on which a nomogram model was developed. Discrimination and calibration analyses were conducted to assess the performance of the model.

A total of 114 patients were enrolled in the final analysis. The median age was 56.5 years, and 53.5% were females. The overall incidence of hypoglycemia after pheochromocytoma resection was 27.2%. The length of hospital stay after surgery was longer in patients with hypoglycemia than those without (P = 0.020). In the multivariable logistic regression analysis, patients who developed hypoglycemia were younger (odds ratio [OR] = 0.95, 95% confidence interval [CI] 0.92 to 0.99, P = 0.015), and were more likely to have elevated preoperative plasma metanephrine level (OR = 7.73, 95% CI 2.00 to 29.85, P = 0.003) and to receive beta blocker intraoperatively (OR = 3.67, 95% CI 1.40 to 9.57, P = 0.008). The nomogram model showed good discrimination (area under receiver operating characteristic curve: 0.798, 95% CI: 0.714 to 0.882) and calibration (Hosmer-Lemeshow test P = 0.720) for predicting postoperative hypoglycemia.

Hypoglycemia was common after pheochromocytoma resection and was associated with poor prognosis. The developed nomogram model incorporating age, elevated preoperative plasma metanephrine level, and intraoperative beta-blocker use can effectively predict postoperative hypoglycemia in patients undergoing pheochromocytoma surgery.

Not applicable.