ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Adrenal Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1628564
This article is part of the Research TopicComorbidities of adrenal-related endocrine disordersView all 10 articles
A Predictive Nomogram for Incomplete Clinical Success After Unilateral Adrenalectomy in Patients with Primary Aldosteronism
Provisionally accepted
- Sichuan Provincial People's Hospital Jinniu Hospital, Chengdu, China
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Introduction: Incomplete clinical success after unilateral adrenalectomy for primary aldosteronism (PA) remains a significant challenge, often characterized by persistent hypertension despite biochemical remission.Objective: This study aimed to develop and validate a preoperative predictive nomogram to estimate the probability of incomplete clinical success in PA patients undergoing unilateral adrenalectomy.Materials and methods: A retrospective analysis was conducted on 58 PA patients who underwent adrenalectomy. Independent predictors of non-complete clinical success were identified using multivariate logistic regression. A nomogram was developed based on age, highest systolic blood pressure (SBP), and lateralization index (LI). Model performance was evaluated through the concordance index (C-index), calibration plots, and decision curve analysis, with internal validation performed via bootstrapping (1,000 resamples).Results: Age (OR 1.117), highest SBP (OR 1.241), and LI (OR 1.044) were independently associated with incomplete clinical success. The nomogram showed strong discriminative ability (C-index: 0.829) and good calibration. Internal validation confirmed its reliability (AUC: 0.844, sensitivity 84.2%, specificity 75.0%). Conclusion: This nomogram offers a reliable, easy-to-use tool for preoperative risk stratification of PA patients, facilitating personalized postoperative management. External validation in multicenter cohorts is warranted.
Keywords: primary aldosteronism, Hypertension management, Unilateral adrenalectomy, predictive model, postoperative outcomes
Received: 14 May 2025; Accepted: 30 Jun 2025.
Copyright: © 2025 Wang, Liu, Lu, Zhu, Zhu, Yang, Zhou and Cao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xu Cao, Sichuan Provincial People's Hospital Jinniu Hospital, Chengdu, China
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