Abstract
Background and Purpose: Some primary aldosteronism (PA) patients with spontaneous hypokalemia achieved incomplete remission after surgical treatment. In this study, we aim to construct a nomogram to predict surgical benefits for PA patients with typical symptoms, which may help doctors assess prognosis and develop treatment plans.
Methods: This retrospective cohort study enrolled 162 patients between January 2017 and January 2024. Baseline characteristics, clinical indicators, and biochemical results were compared among patients with different clinical and biochemical outcomes. A nomogram was developed and internally validated with risk factors selected from univariate and multivariate logistic regression analyses.
Results: Respectively, complete clinical and biochemical success was achieved in 69 patients (42.6%) and 129 patients (79.6%). Five risk factors for incomplete remission were used to develop a nomogram. The area under the receiver operating characteristic curve (AUC) was 0.856 (0.788-0.924) in the training dataset and 0.726 (0.580-0.872) in the validation dataset. The calibration curve showed good agreement, and the decision curve analysis demonstrated clinical utility of this model.
Conclusions: PA patients with older age, higher systolic blood pressure, lower plasma aldosterone, more than 5 years of hypertension, and an adrenal gland mass on the left side or both sides had more probability to achieve incomplete remission after the surgery.
Keywords
References
The published articles will be distributed under the Creative Commons Attribution 4.0 International License (CC BY). It is allowed to copy and redistribute the material in any medium or format, and remix, transform, and build upon it for any purpose, even commercially, as long as appropriate credit is given to the original author(s), a link to the license is provided and it is indicated if changes were made. Users are required to provide full bibliographic description of the original publication (authors, article title, journal title, volume, issue, pages), as well as its DOI code. In electronic publishing, users are also required to link the content with both the original article published in Journal of Medical Biochemistry and the licence used.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.