Risk factors for postoperative complications after adrenalectomy for phaeochromocytoma: multicentre cohort study
Year: 2023
Type: article
Study design: Observational Study
Abstract: BACKGROUND: To determine the incidence and risk factors for postoperative complications and prolonged hospital stay after adrenalectomy for phaeochromocytoma. METHODS: Demographics, perioperative outcomes and complications were evaluated for consecutive patients who underwent adrenalectomy for phaeochromocytoma from 2012 to 2020 in nine high-volume UK centres. Odds ratios were calculated using multivariable models. The primary outcome was postoperative complications according to the Clavien---Dindo classification and secondary outcome was duration of hospital stay. RESULTS: Data were available for 406 patients (female n = 221, 54.4 per cent). Two patients (0.5 per cent) had perioperative death, whilst 148 complications were recorded in 109 (26.8 per cent) patients. On adjusted analysis, the age-adjusted Charlson Co-morbidity Index ≥3 (OR 8.09, 95 per cent c.i. 2.31 to 29.63, P = 0.001), laparoscopic converted to open (OR 10.34, 95 per cent c.i. 3.24 to 36.23, P <0.001), and open surgery (OR 11.69, 95 per cent c.i. 4.52 to 32.55, P <0.001) were independently associated with postoperative complications. Overall, 97 of 430 (22.5 per cent) had a duration of stay ≥5 days and this was associated with an age-adjusted Charlson Co-morbidity Index ≥3 (OR 4.31, 95 per cent c.i. 1.08 to 18.26, P = 0.042), tumour size (OR 1.15, 95 per cent c.i. 1.05 to 1.28, P = 0.006), laparoscopic converted to open (OR 32.11, 95 per cent c.i. 9.2 to 137.77, P <0.001), and open surgery (OR 28.01, 95 per cent c.i. 10.52 to 83.97, P <0.001). CONCLUSION: Adrenalectomy for phaeochromocytoma is associated with a very low mortality rate, whilst postoperative complications are common. Several risk factors, including co-morbidities and operative approach, are independently associated with postoperative complications and/or prolonged hospitalization, and should be considered when counselling patients.
Source: BJS Open
Authors: Alessandro Parente, Sivesh K Kamarajah, Joseph P Thompson, Charlotte Crook, Sebastian Aspinall, Ross Melvin, Michael J Stechman, Helen Perry, Sabapathy P Balasubramanian, Arslan Pannu, Fausto F Palazzo, Klaas Van Den Heede, Fiona Eatock, Hannah Anderson, Helen Doran, Kelvin Wang, Johnathan Hubbard, Abdulaziz Aldrees, Susannah L Shore, Clare Fung, Alison Waghorn, John Ayuk, Davinia Bennett, Robert P Sutcliffe
Institutions: Queen Elizabeth Hospital Birmingham, University of Birmingham, Aberdeen Royal Infirmary, University Hospital of Wales, Sheffield Teaching Hospitals NHS Foundation Trust, Hammersmith Hospital, Royal Victoria Hospital, Salford Royal NHS Foundation Trust, Salford Royal Hospital, St Thomas' Hospital, Royal Liverpool and Broadgreen University Hospital NHS Trust, Broadgreen Hospital
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,442
OpenAlex ID: W4387080451