title: Outcome of abdominal aortic aneurysm repair in patients with previous spinal cord injury in the Department of Veterans' Affairs hospitals.
abstract: A retrospective review was carried out to determine the morbidity and mortality of abdominal aortic aneurysm repair in patients with previous spinal cord injury. A population-based study utilizing computer records on all patients in Department of Veterans' Affairs medical centers from 1987-1991 identified 31 patients with spinal cord injury who underwent subsequent infrarenal abdominal aortic aneurysm repair. Additional information was obtained from individual medical records. Some twenty patients (65%) were paraplegics and 11 (35%) were quadriplegics. Aneurysms were most commonly discovered incidentally during work-up of other conditions. All patients had no symptoms referable to their abdominal aortic aneurysm. In total, 29 patients (94%) underwent elective operations. The complication rate (57%) involved mostly pulmonary, cutaneous or urinary tract morbidity. The 30-day mortality rate was 3% for elective abdominal aortic aneurysm repair. Two patients were operated upon as emergencies for rupture, with one operative death. Long-term follow-up revealed a median survival duration of 5.4 years after aneurysm repair. In conclusion, abdominal aortic aneurysm repair in patients with previous spinal cord injury has a low mortality rate. Postoperative complications are often related to spinal cord injury and are potentially preventable; thus, such injury should not preclude surgical intervention for abdominal aortic aneurysm.
authors.affiliation: Department of Surgery, St Louis University School of Medicine, MO 63110-0250, USA.
authors.forename: D L
authors.initials: DL
authors.lastname: Jacobs
authors.forename: W E
authors.initials: WE
authors.lastname: Longo
authors.forename: G J
authors.initials: GJ
authors.lastname: Peterson
authors.forename: L W
authors.initials: LW
authors.lastname: McKirgan
authors.forename: K S
authors.initials: KS
authors.lastname: Virgo
authors.forename: F E
authors.initials: FE
authors.lastname: Johnson
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010264:Paraplegia / Q000401:mortality / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D011782:Quadriplegia / Q000401:mortality / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000401:mortality / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome