Factors influencing postoperative of hypertension remission in adrenal cavernous hemangioma: A multicenter retrospective cohort study

Figure 1 Flowchart of patient selection and inclusion. A total of 240 patients with adrenal cavernous hemangioma treated between 2003 and 2023 were screened, and 102 hypertensive adrenal cavernous hemangioma patients meeting the imaging, pathological and follow-up eligibility criteria were included in the final analysis. ACH: Adrenal cavernous hemangioma; RAAS: Renin-angiotensin-aldosterone system; ROC: Receiver operating characteristic.

Figure 2 Comparison of area under the curve values between the combined predictor and individual factors. The area under the curve of the combined predictor was 0.872 (95% confidence interval: 0.791-0.934), which was significantly higher than that of each individual factor (P < 0.05, Delong test). ROC: Receiver operating characteristic; ACH: Adrenal cavernous hemangioma; RAAS: Renin-angiotensin-aldosterone system.

Figure 3 Calibration curve of the combined predictor. The curve showed good agreement between predicted probabilities and actual remission rates (slope = 0.98, intercept = 0.02), indicating no significant over fitting or under fitting. The critical value l = 12.57 achieved 85.7% accuracy in predicting failure of postoperative hypertension remission. AUC: Area under the curve.

Figure 4 Decision curve analysis showing the net benefit of the combined predictor vs individual factors for postoperative hypertension remission. The black solid line with gray shading represents the combined predictor (95% confidence interval), while colored dashed lines denote individual factors. The red and gray dashed lines indicate treat-all and treat-none strategies. RAAS: Renin-angiotensin-aldosterone system.