Prognostic models to predict complete resolution of hypertension after adrenalectomy in primary aldosteronism: A systematic review and meta‐analysis

Abstract

Complete resolution of hypertension (CRH) after adrenalectomy for primary aldosteronism is far from a certainty. Although several prognostic models have been proposed to predict outcome after adrenalectomy, studies have not clarified which of the available models can be used reliably in clinical practice. To identify, describe and appraise all prognostic models developed to predict CRH, and meta-analyse their predictive performances. We searched MEDLINE, Embase and Web of Science for development and validation studies of prognostic models. After selection, we extracted descriptive statistics and aggregated area under the receiver operator curve (AUC) using metaanalysis. From 25 eligible studies, we identified 12 prognostic models used for predicting CRH after total adrenalectomy in primary aldosteronism. We report the results for 3 models that had available data from at least 3 external validation studies: the primary aldosteronism surgical outcome (PASO) score

Letter to the Editor: Validation of the aldosteronoma resolution score as a predictive resolution score of hypertension after unilateral adrenalectomy for primary aldosteronism in a North‐African population

“…4 These models have shown comparable discrimination performance to predict complete resolution of hypertension in primary aldosteronism. 5 Despite the availability of these models, there is a shortage of sufficient head-to-head comparisons. Recent systematic literature reviews, including "Assessment of performance of stratum-specific likelihood ratios of the ARS for predicting hypertension cure after adrenalectomy for primary aldosteronism: a systematic review and meta-analysis" 2 and "Prognostic models to predict complete resolution of hypertension after adrenalectomy in primary aldosteronism: A systematic review and meta-analysis," 5 have highlighted this gap.In conclusion, while the ARS is a valuable tool, further research comparing it with other prognostic models could provide more comprehensive guidance for clinicians.…”