title: Evaluation of prognostic factors in the surgical treatment of adrenal gland tumors in dogs: 41 cases (1999-2005).
abstract: OBJECTIVE
  To identify preoperative predictors of survival and assess intraoperative and postoperative complications and survival rates for dogs undergoing adrenalectomy.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  41 dogs that underwent adrenalectomy.
  
  
  METHODS
  Records were reviewed to collect data regarding preoperative variables. Intraoperative and postoperative variables were also recorded. Variables were evaluated for association with survival duration via log-rank analysis for categoric variables and by use of Cox proportional hazards. Median survival times were calculated by use of Kaplan-Meier life table analysis.
  
  
  RESULTS
  9 (22.0%) dogs did not survive to discharge. Intraoperative mortality rate was 4.8%. Overall Kaplan-Meier median survival time was 690 days. Variables significantly associated with shorter survival times included preoperative weakness or lethargy, thrombocytopenia, increased BUN concentration, increased partial thromboplastin time (PTT), increased aspartate transaminase (AST) activity, hypokalemia, intraoperative hemorrhage, and concurrent nephrectomy. Postoperative variables significantly associated with shorter survival times included pancreatitis and renal failure. In multivariate analysis, preoperative hypokalemia, preoperative increased BUN concentration, and concurrent nephrectomy were significantly associated with a shorter survival time.
  
  
  CONCLUSIONS
  A high mortality rate was associated with adrenalectomy in dogs; however, those that survived until discharge from a hospital had long survival times. Preoperative factors associated with a shorter survival time were weakness or lethargy, thrombocytopenia, increased BUN concentration, increased PTT, increased AST activity, and hypokalemia. Studies are needed to evaluate how treatment for these factors may affect or change outcome after adrenalectomy. Dogs with adrenal masses that require concurrent nephrectomy and cause intraoperative hemorrhage have a guarded prognosis.
authors.affiliation: Animal Medical Center, New York, NY 10021, USA.
authors.forename: Pamela
authors.initials: P
authors.lastname: Schwartz
authors.forename: Janet R
authors.initials: JR
authors.lastname: Kovak
authors.forename: Alexandra
authors.initials: A
authors.lastname: Koprowski
authors.forename: Lori L
authors.initials: LL
authors.lastname: Ludwig
authors.forename: Sebastien
authors.initials: S
authors.lastname: Monette
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Bergman
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery / Q000662:veterinary*; D000315:Adrenalectomy / Q000379:methods / Q000662:veterinary*; D000818:Animals; D004283:Dog Diseases / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D004285:Dogs; D005260:Female; D053208:Kaplan-Meier Estimate; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000662:veterinary; D011300:Preoperative Care / Q000662:veterinary; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome