Open AccessLaparoscopic Adrenalectomy Is Beneficial for the Health-Related Quality of Life of Older Patients with Primary Aldosteronism
Author(s) -
Yoshihide Kawasaki,
Shigeto Ishidoya,
Ryo Morimoto,
Yoshikiyo Ono,
Kei Omata,
Yuta Tezuka,
Naoki Kawamorita,
Shinichi Yamashita,
Koji Mitsuzuka,
Fumitoshi Satoh,
Akihiro Ito
Publication year - 2021
Publication title -
urologia internationalis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.771
H-Index - 53
eISSN - 1423-0399
pISSN - 0042-1138
DOI - 10.1159/000518165
Subject(s) - medicine , primary aldosteronism , quality of life (healthcare) , sf 36 , prospective cohort study , adrenalectomy , multivariate analysis , cohort , mental health , physical therapy , health related quality of life , blood pressure , psychiatry , nursing , disease
Objective: Laparoscopic adrenalectomy (LADX) improves hypertension in patients with primary aldosteronism (PA). However, the antihypertensive impact of LADX appears restricted in older patients with PA. In this study, we evaluated the impact of LADX in older patients focusing on the health-related quality of life (HRQoL). Methods: A total of 156 patients with PA who underwent LADX in a single institution were enrolled in this prospective cohort study. The patients were divided into 2 groups, with a boundary of 60 years. The HRQoL was evaluated using the Medical Outcomes Study’s 36-Item Short-Form Health Survey version 2 (SF-36v2) questionnaire before and after LADX. Demographics, clinical features, antihypertensive drugs before and after surgery, and perioperative evaluation were recorded. We compared all scale scores and summed scores between groups. Multivariate regression models were used to determine the associations between various covariables and the HRQoL. Results: In the older PA patients, most subscales of HRQoL at baseline were lower than the national standard values. The antihypertensive drug-free rate by LADX was only 21% in older patients, compared to 58% in younger patients. However, a significant improvement in mental HRQoL was observed after LADX ( p = 0.002). The much preoperative antihypertensive drugs, lower preoperative potassium level, and smaller degree of comorbidities were predictors of improved mental HRQoL by LADX on multivariate analyses. Conclusion: The older PA patients showed lower mental HRQOL than the national standard populations. Although antihypertensive effects were limited for these patients, LADX was beneficial as PA treatment via improvement of mental HRQoL.