Development And Validation A Nomogram For Predicting Blood Pressure Change Failure In Patients With Pheochromocytoma Concomitant Hypertension After Adrenalectomy

Objective: Although pheochromocytoma is a common cause of secondary hypertension,which is usually considered curable,part of patients still suffer from hypertension after successful adrenalectomy.Therefore,we aim to develop and validate a nomogram for predicting blood pressure change failure in patients with pheochromocytoma concomitant hypertension after adrenalectomy.Methods: The development cohort of this study consisted of 259 patients with pheochromocytoma who underwent adrenalectomy at our center between January 1,2007,and December 31,2018.The patient’s clinicopathologic data were recorded.LASSO regression was used to reduce and select the feature of data.And then using multivariate logistic regression analysis to develop the prediction model.An independent cohort consisting of 110 consecutive patients from 1 January 2019 and31 December 2021 was used for validation.The performance of this nomogram was assessed with discrimination,calibration,and clinical usefulness.Results: In this study,40.9% and 46.4% of patients experienced blood pressure change failure in the development and validation cohorts,respectively.We found that patients with older age,longer duration of hypertension,and comorbidity with cardiovascular events were more likely to suffer from blood pressure change failure.In the validation cohort,the model manifested great discrimination with an AUROC of 0.996(P < 0.001)and good calibration(unreliability test,P = 0.359).Decision curve analysis demonstrated that the model was also clinically useful.Conclusions: This study presented a reliable nomogram that could facilitate the preoperative individualized prediction of blood pressure change failure after successful adrenalectomy in patients with pheochromocytoma,which may help in decision-making in perioperative treatment and follow-up strategies.