A global real-world study assessing total time to adrenalectomy in primary aldosteronism
Authors' conclusion
Primary aldosteronism management is time-consuming worldwide, especially for subtyping tests and adrenalectomy. While omitting AVS reduces overall time, patients are less likely to achieve biochemical cure post-adrenalectomy.
Study context
- Population
- Patients with primary aldosteronism (PA) who underwent adrenalectomy from January 1, 2018, to October 30, 2022, 39 centres in 15 countries; mean age 49.3 ± 11.1 years, 44.5% women
- Participants
- 861 patients
- Exposure
- Countries without routine adrenal vein sampling (AVS) vs countries with routine AVS
- Outcome
- Total time from first presentation to adrenalectomy (TTA) and intervals between each stage (screening, confirmatory, subtyping, adrenalectomy)
Methodological detailsinternational, multicentre, 39 centres from 15 countries
- International
- Multicentre
- 39 centres from 15 countries
Main finding
As reported in the abstract
Total time to adrenalectomy (TTA)
- Overall median time to adrenalectomy (TTA)
- 13.5 months, IQR: 6.6-24.5
- Median interval, screening
- 0.1 months
- Median interval, confirmatory
- 1.0 months
- Median interval, subtyping
- 4.1 months
- Median interval, adrenalectomy
- 4.3 months
Observational data: associations, not effects.
Further findings
TTA by country AVS practice · shorter TTA without AVS
P < 0.001
Absent/partial biochemical success post-adrenalectomy · greater likelihood without AVS · Primary Aldosteronism Surgery Outcome criteria
P < 0.001
Factors associated with longer TTA (multivariable analysis)
- Increase in median TTA per additional AVS procedure
- 5.4 months
- Other factors associated with longer TTA: adrenalectomy post-COVID-19, younger age, additional screening tests
Original publication
A global real-world study assessing total time to adrenalectomy in primary aldosteronism. Eur J Endocrinol. Published 17 June 2025. doi:10.
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