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Purpose <p>Adrenalectomy for pheochromocytoma (PHEO) presents a significant challenge due to the high incidence of early hospital readmission (ER). This study evaluated the incidence and risk factors of ER for PHEO within 30 days of adrenalectomy.</p> Methods <p>A retrospective analysis of 346 patients &gt; 18 years with unilateral PHEO who underwent adrenalectomy between September 2012 and September 2024. The patients were categorised into ER (<i>n</i> = 49) and no ER (<i>n</i> = 297) groups. Logistic regression analyses were performed to predict risk factors for ER.</p> Results <p>The most common causes of ER were postoperative maintained hypotension (42.9%), bleeding (6.1%), ileus (24.5%), wound infection (4.1%), hyperkalemia (8.2%), pneumonia (2%), intra-abdominal abscess (2%), acute MI (4.1%), and colonic injury (6.1%). Most postoperative complications were Clavien-Dindo grade II (<i>n</i> = 40, 81.6%). Two perioperative deaths (4%) occurred in the ER group. Logistic regression showed that low body mass index (OR 0.849, 95% CI, 0.748–0.964; <i>p</i> = 0.012), tumor size &lt; 5&#xa0;cm (OR 0.096, 95% CI, 0.030–0.310; <i>p</i> &lt; 0.001), and low ASA (OR 0.435, 95% CI, 0.249–0.761; <i>p</i> = 0.003) were associated with risk reduction for ER while malignancy (OR 5.302, 95% CI, 1.214–23.164; <i>p</i> = 0.027), open approach(OR 12.247, 95% CI, 5.227–28.694; <i>p</i> &lt; 0.001), and intraoperative complications (OR 19.149, 95% CI, 7.091–51.710; <i>p</i> &lt; 0.001) were associated with risk increase of ER.</p> Conclusion <p>Postoperatively maintained hypotension and ileus were the most common causes of ER. Low body mass index, tumour size &lt; 5&#xa0;cm, and low ASA were risk reductions for ER, while malignancy, open approach, and intraoperative complications were the independent risk increase factors.</p>

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Early readmission after adrenalectomy for pheochromocytoma. A retrospective study

  • 期刊论文

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  • 发表日期：

    2025年5月8日

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  • Tamer A. A. M. Habeeb,
  • Abd Al-Kareem Elias,
  • Abdelmonem A. M. Adam,
  • Mohamed A. Gadallah,
  • Saad Mohamed Ali Ahmed,
  • Ahmed Khyrallh,
  • Mohammed H. Alsayed,
  • Esmail Tharwat Kamel Awad,
  • Emad A. Ibrahim,
  • Mohamed Fathy Labib,
  • Sobhy Rezk Ahmed Teama,
  • Mahmoud Hassib Morsi Badawy,
  • Mohamed Ibrahim Abo Alsaad,
  • Abouelatta KH Ali,
  • Hamdi Elbelkasi,
  • Mahmoud Ali Abou Zaid,
  • Ibtsam AbdElMaksoud Mohamed El Shamy,
  • Boshra Ali Ali El-houseiny,
  • Mahmoud El Azawy,
  • Ahmed Elhoofy,
  • Ali Hussein Khedr,
  • Abdelrahman Mohamed Hasanin Nawar,
  • Ahmed Salah Arafa,
  • Ahmed Mesbah Abdelaziz,
  • Abdelfatah H. Abdelwanis,
  • Mostafa M. Khairy,
  • Ahmed M. Yehia,
  • Ahmed Kamal el Taher

摘要

Purpose

Adrenalectomy for pheochromocytoma (PHEO) presents a significant challenge due to the high incidence of early hospital readmission (ER). This study evaluated the incidence and risk factors of ER for PHEO within 30 days of adrenalectomy.

Methods

A retrospective analysis of 346 patients > 18 years with unilateral PHEO who underwent adrenalectomy between September 2012 and September 2024. The patients were categorised into ER (n = 49) and no ER (n = 297) groups. Logistic regression analyses were performed to predict risk factors for ER.

Results

The most common causes of ER were postoperative maintained hypotension (42.9%), bleeding (6.1%), ileus (24.5%), wound infection (4.1%), hyperkalemia (8.2%), pneumonia (2%), intra-abdominal abscess (2%), acute MI (4.1%), and colonic injury (6.1%). Most postoperative complications were Clavien-Dindo grade II (n = 40, 81.6%). Two perioperative deaths (4%) occurred in the ER group. Logistic regression showed that low body mass index (OR 0.849, 95% CI, 0.748–0.964; p = 0.012), tumor size < 5 cm (OR 0.096, 95% CI, 0.030–0.310; p < 0.001), and low ASA (OR 0.435, 95% CI, 0.249–0.761; p = 0.003) were associated with risk reduction for ER while malignancy (OR 5.302, 95% CI, 1.214–23.164; p = 0.027), open approach(OR 12.247, 95% CI, 5.227–28.694; p < 0.001), and intraoperative complications (OR 19.149, 95% CI, 7.091–51.710; p < 0.001) were associated with risk increase of ER.

Conclusion

Postoperatively maintained hypotension and ileus were the most common causes of ER. Low body mass index, tumour size < 5 cm, and low ASA were risk reductions for ER, while malignancy, open approach, and intraoperative complications were the independent risk increase factors.