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. 2000 Feb;69(2):409-14.
doi: 10.1016/s0003-4975(99)01478-2.

Mortality and paraplegia after thoracoabdominal aortic aneurysm repair: a risk factor analysis

J S Coselli  1 , S A LeMaire, C C Miller 3rd, Z C Schmittling, C Köksoy, J Pagan, P E Curling
Affiliations

Mortality and paraplegia after thoracoabdominal aortic aneurysm repair: a risk factor analysis

J S Coselli et al. Ann Thorac Surg. 2000 Feb.

Abstract

Background: Recent recommendations regarding thoracoabdominal aortic aneurysm (TAAA) management have emphasized individualized treatment based on balancing a patient's calculated risk of rupture with their anticipated risk of postoperative death or paraplegia. The purpose of this study was to enhance this risk-benefit decision by providing contemporary results and determining which preoperative risk factors currently predict mortality and paraplegia after TAAA surgery.

Methods: Risk factor analyses based on data regarding 1,220 consecutive patients undergoing TAAA repair from 1986 through 1998 were performed using multiple logistic regression with step-wise model selection.

Results: The 30-day mortality rate was 4.8% (58 of 1,220) and the incidence of paraplegia was 4.6% (56 of 1,206). For elective cases, predictors of operative mortality included renal insufficiency (p = 0.0001), increasing age (p = 0.0005), symptomatic aneurysms (p = 0.0059), and extent II aneurysms (p = 0.0054). Extent II aneurysms (p = 0.0023) and diabetes (p = 0.0402) were predictors of paraplegia.

Conclusions: These risk models may assist in decisions regarding elective TAAA operations. For patients who are acceptable candidates, contemporary surgical management provides favorable results.

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