PREDICTIVE MODEL FOR COLONIC ISCHEMIA FOLLOWING ABDOMINAL AORTIC-ANEURYSM REPAIR

Colonic ischemia is a complication of abdominal aortic aneurysm (AAA) repair that results in significant morbidity and mortality. Numerous c auses of colonic ischemia have been reported, but no attempt has been made to identify factors that predict its development. This study iden tifies those factors that increase risk for colonic ischemia following AAA repair and develops a predictive model for identification of pati ents who need more aggressive intervention. The records of 12 patients who underwent AAA repair at the authors' institution from 1987 to 199 1 and developed colonic ischemia after surgery were reviewed along wit h a control group of 67 randomly chosen patients who also underwent AA A repair. Clinical factors in the following categories: vascular disea se risk factors, medical history, presentation of aortic aneurysm, ope rative procedure, and postoperative course were examined. Fifteen fact ors, found to be significantly associated with the development of colo nic ischemia (p<0.01), were used for the logistic analysis. Three fact ors: aneurysm rupture as indication for repair, coagulopathy, and intr aoperative hypotension were identified as independent predictors. The presence of one of these factors gave an approximate probability of 10 %, two factors 50%, and three factors 90% for development of colonic i schemia.