Crawford et al identified risk factors for a patient developing a neuromuscular deficit in the lower extremities following surgery to repair a thoracoabdominal aortic aneurysm. The authors are from Baylor College of Medicine and The Methodist Hospital in Houston.
Basis for neuromuscular deficit: ischemia to the spinal cord
Parameters:
(1) rupture of the aneurysm
(2) reattached intercostals
(3) dissection of the aneurysm
(4) extent of disease (based on Crawford group)
where:
• Transection of the intercostal arteries occurred with more extensive aneurysm. The patency of the arteries after reattachment could not be confirmed.
Parameters
Findings
Points
rupture of the aneurysm
no
0
yes
1
intercostals
not detached
0
reattached during surgery
1
dissection of the aneurysm
no
0
yes
1
Extent of Disease
Points
Group I (predominantly thoracic)
0
Group II (entire descending thoracic and abdominal)
0.905
Group III (distal thoracic and abdominal)
-1.098
Group IV (predominantly abdominal)
-1.526
X =
= (2.261 * (points for aneurysm rupture)) + (1.016 * (points for intercostals)) + (0.830 * (points for dissection)) + (points for disease extent) - 2.982
probability of neuromuscular deficit after surgery =
= 1 / (1 + EXP((-1) * X))
To read more or access our algorithms and calculators, please log in or register.
