Analysis of factors contributing to improved outcome for carotid endarterectomy.

Abstract:

:Since carotid endarterectomy was revitalized following the North American Symptomatic Carotid Endarterectomy Trial and Asymptomatic Carotid Atherosclerosis Study, results have improved. However, types of carotid endarterectomy, indications, risk factors, surgical factors, techniques, and other treatment modalities may be associated with outcomes of carotid endarterectomy. The purpose of this study was to identify those factors in a broad-based carotid endarterectomy patient. This study involved review of the data from 3,644 patients undergoing carotid endarterectomy in New York State hospitals. A multivariate statistical model was used to identify significant patient risk factors to examine the association of the process of care and surgical factors, including surgical specialty for outcome of carotid endarterectomy. In-hospital death and stroke rate overall was 1.84%. After adjustment for patient risk factors, specific processes of care, such as eversion endarterectomy, protamine, heparin, or shunt, were associated with lower adverse outcomes relative to patients undergoing carotid endarterectomy without these processes. Similarly, patients undergoing carotid endarterectomy by vascular surgeons had lower adverse outcomes compared to neurosurgeons and general surgeons. This retrospective review showed that processes of care and surgical specialty were significant factors that contributed to outcomes following carotid endarterectomy.

journal_name

Semin Vasc Surg

authors

Shah DM,Darling RC 3rd,Chang BB,Paty PS,Kreienberg PB,Roddy SP,Ozsvath KJ,Mehta M

doi

10.1016/s0895-7967(04)00052-3

subject

Has Abstract

pub_date

2004-09-01 00:00:00

pages

257-9

issue

3

eissn

0895-7967

issn

1558-4518

pii

S0895796704000523

journal_volume

17

pub_type

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