Document Detail


Estimating group mortality and paraplegia rates after thoracoabdominal aortic aneurysm repair.
MedLine Citation:
PMID:  12607663     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Most clinical studies regarding thoracoabdominal aortic aneurysm (TAAA) surgery are retrospective comparisons involving heterogeneous groups of patients. Risk models that evaluate susceptibility bias enhance interpretation of these intergroup comparisons. The purpose of this analysis was to derive group risk models for mortality and paraplegia after TAAA repair. METHODS: Data regarding 1,220 consecutive patients undergoing TAAA repair were analyzed via multiple logistic regression with stepwise model selection. Categorical preoperative risk factors that predicted 30-day mortality and paraplegia were used to develop risk models. RESULTS: Fifty-eight patients (4.8%) died within 30 days and 56 patients (4.6%) developed paraplegia or paraparesis. Predictors of mortality were rupture, renal insufficiency, symptomatic aneurysms, and Crawford extent II repairs. Extent of repair and acute presentation were predictors of paraplegia. The derived risk models estimated mortality and paraplegia rates that correlated well with actual frequencies reported in other contemporary series (regression slopes = 0.87 and 1.06, respectively). CONCLUSIONS: The derived risk models accurately estimate paraplegia and mortality rates in groups of patients. Prospective model validation will be required to confirm their accuracy.
Authors:
Scott A LeMaire; Charles C Miller; Lori D Conklin; Zachary C Schmittling; Joseph S Coselli
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  75     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-02-27     Completed Date:  2003-03-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  508-13     Citation Subset:  AIM; IM    
Affiliation:
Michael E. DeBakey Department of Surgery, Division of Cardiothoracic Surgery, Baylor College of Medicine, Houston, Texas 77030, USA. slemaire@bcm.tmc.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal / epidemiology,  surgery*
Aortic Aneurysm, Thoracic / epidemiology,  surgery*
Blood Vessel Prosthesis Implantation / adverse effects*,  mortality*
Comorbidity
Female
Heart Bypass, Left
Hospital Mortality
Humans
Male
Middle Aged
Paraplegia / etiology*
Risk Assessment

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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