Abstract:
OBJECTIVES:To assess timeliness of carotid endarterectomy services in the United Kingdom. DESIGN:Observational study with follow-up to March 2008. SETTING:UK hospitals performing carotid endarterectomy. PARTICIPANTS:UK surgeons undertaking carotid endarterectomy from December 2005 to December 2007. MAIN OUTCOME MEASURES:Provision and speed of delivery of appropriate assessments of patients; carotid endarterectomy and operative mortality; 30 day postoperative mortality. RESULTS:240 (61% of those eligible) consultant surgeons took part from 102 (76%) hospitals and trusts. Of 9913 carotid endarterectomies recorded on hospital episode statistics, 5513 (56%) were included. Of the patients who underwent endarterectomy, 83% had a history of transient ischaemic attack or stroke. Of these recently symptomatic patients, 20% had their operation within two weeks of onset of symptoms and 30% waited more than 12 weeks. Operative mortality was 0.5% during the inpatient stay and 1.0% (95% confidence interval 0.7% to 1.3%) by 30 days. CONCLUSION:Only 20% of symptomatic patients had surgery within the two week target time set by the National Institute for Health and Clinical Excellence (NICE). Although operative mortality rates are comparable with those in other countries, some patients might experience disabling or fatal stroke while waiting for surgery and hence not be included in operative statistics. Major improvements in services are necessary to enable early surgery in appropriate patients in order to prevent strokes.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Halliday AW,Lees T,Kamugasha D,Grant R,Hoffman A,Rothwell PM,Potter JF,Horrocks M,Naylor R,Rudd AG,Carotid Endarterectomy Steering Group.,Clinical Effectiveness and Evaluation Unit, Royal College of Physicians.,Vascular Society odoi
10.1136/bmj.b1847subject
Has Abstractpub_date
2009-06-04 00:00:00pages
b1847eissn
0959-8138issn
1756-1833journal_volume
338pub_type
杂志文章,多中心研究abstract:OBJECTIVE:To compare blood pressure control, satisfaction, and adherence to drug treatment in patients with treated hypertension followed up by their family physicians either every three months or every six months for three years. DESIGN:Randomised equivalence clinical trial. Settings 50 family practices in south east...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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journal_title:BMJ (Clinical research ed.)
pub_type: 传,历史文章,杂志文章
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journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
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doi:10.1136/bmj.322.7281.276
更新日期:2001-02-03 00:00:00
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pub_type: 杂志文章,meta分析,评审
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更新日期:1992-02-08 00:00:00
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更新日期:2012-10-31 00:00:00
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更新日期:2017-01-19 00:00:00
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pub_type: 杂志文章
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2011-05-19 00:00:00
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更新日期:2003-08-30 00:00:00
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pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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pub_type: 杂志文章,评审
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2008-05-10 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2009-04-02 00:00:00
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更新日期:1995-09-09 00:00:00
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更新日期:1989-01-07 00:00:00