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

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


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.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Aortic Aneurysm, Abdominal / mortality*
  • Aortic Aneurysm, Thoracic / mortality*
  • Cardiac Surgical Procedures / mortality
  • Female
  • Humans
  • Male
  • Middle Aged
  • Paraplegia / etiology*
  • Postoperative Complications*
  • Risk Assessment
  • Risk Factors
  • Survival Analysis