• Sergey Efremov, Mikhail Alexeev, Oleg Kuleshov, Alexander Safronov, Vyacheslav Ryndin, Dina Rebrova, and Elisei Fedorov.
• Department of Anesthesiology and Intensive Care, Saint-Petersburg State University Hospital, St. Petersburg, Russian Federation. Electronic address: sergefremov@mail.ru.
• J. Cardiothorac. Vasc. Anesth. 2023 Jul 1; 37 (7): 123012351230-1235.

ObjectivesTo evaluate the risk factors for postoperative vasopressor requirement among patients with pheochromocytoma undergoing retroperitoneal adrenalectomy. The primary outcome was postoperative hypotension requiring vasopressor support.DesignA single-center retrospective observational study.SettingAt a university hospital.ParticipantsAdults who underwent unilateral adrenalectomy for pheochromocytoma between October 2015 and February 2020.InterventionsNone.Measurements And Main ResultsOverall, 201 patients were included. Postoperative vasopressor requirements were observed in 39 (19.4%) patients, and were associated with baseline coronary artery disease (CAD) (odds ratio [OR] 6.21, 95% CI) 2.48-15.52; p = 0.0001), maximal systolic blood pressure (maxSBP) >195 mmHg (OR 3.71, 95% CI 1.53-8.95; p = 0.0035), and >5.1-fold increase in the upper limit of normal values for baseline adrenergic activity (OR 4.9, 95% CI 1.93-12.55; p = 0.0008). The area under the receiver operating characteristic curve of the predictive model was 0.804 (95% CI 0.742-0.856).ConclusionA MaxSBP >195 mmHg, baseline adrenergic activity >5.1-fold increase in the upper limit of normal values, and baseline CAD could predict postresection requirements for vasoactive support. Prospective multicenter international studies are required to develop and validate universally accepted predictive models for postoperative complications in patients after adrenalectomy for pheochromocytoma.Copyright © 2023 Elsevier Inc. All rights reserved.

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