Predictors of perioperative hypertensive crisis in patients with pheochromocytoma: A retrospective study

Abstract

BackgroundPheochromocytoma is a rare adrenal gland tumor.The definitive treatment is adrenalectomy. Because of its secretory nature, appropriate preoperative treatment is essential to prevent hypertensive crisis(HTC) during surgery.Despite this management,HTC is common and can cause life-threatening complications.AimOur aim was to study variables that may affect HTC despite preoperative management.MethodsIn a retrospective study,among 126 medical records of patients with adrenal tumor who referred to Alzahra hospital, Isfahan,Iran,between 2013 and 2021,52 patients who took proper preparation for surgery were included.ResultsAnalysis of these patients showed that 12 patients experienced HTC. Among many potential predictors, we observed in multivariate analysis that patients with tumors size > 33.5mm in imaging were at higher risk for experiencing HTC (P = 0.038,OR:13.1,CI:1.26–135.26); taking amlodipine to help reducing blood pressures(BPs) was another significant predictor (P = 0.05,OR:5.1,CI:0.97–56.74). Mean values of systolic BP(SBP) and diastolic BP(DBP) before surgery in HTC group was more, although it wasn’t statistically significant.ConclusionTumor sizes > 33.5mm(imaging)and necessity of administering amlodipine to control BP were predictors of HTC but when reported by pathology,it wasn’t significantly different and it suggests that tumor size has no effect on HTC.However, due to rarity of pheochromocytoma, multicenter studies with larger sample size for providing more reliable results are suggested.