Diabetes Mellitus as a Risk Factor for Early Outcome After Carotid Endarterectomy – a Population-based Study

Autor: committee:, Abdi Abdi Ahari (on behalf of the Swedish Vascular Registry (Swedvasc) Steering, Bergqvist, David, Troëng, Thomas, Elfström, Johan, Hedberg, Bengt, Ljungström, K.-G., Norgren, Lars, Örtenwall, Per
Zdroj: European Journal of Vascular and Endovascular Surgery; August 1999, Vol. 18 Issue: 2 p122-126, 5p
Abstrakt: Background and purpose: to determine if diabetes mellitus is a risk factor for outcome after carotid endarterectomy (CEA). Methods: the outcome and complications of all vascular procedures performed in Sweden are registered prospectively in the Swedish Vascular Registry (Swedvasc) and form the basis of this report. During the 10-year period 1987–96 2622 CEAs were analysed for notified complications. Results: of the 2622 CEAs, 341 (13%) were performed on diabetics and 2281 (87%) on non-diabetics. Patients with diabetes presented at a younger age (67.1±8.3 years vs. 68.2±8.3 years p =0.028), were more likely to have a history of hypertension (61.9% vs. 50% p =0.001) and were less often smokers (34.9% vs. 43.2% p =0.001). Diabetics presented more often with minor stroke (41.3% vs. 30.8% p =0.002) and non-diabetics more often with amaurosis fugax (18.9% vs. 14.4% p =0.04). Diabetics had a higher 30-day mortality (3.2% vs. 1.4% p =0.02). The 30-day neurologic and cardiac morbidity did not differ. The 1-year mortality was 7.9% in diabetics and 4.4% in non-diabetics (p =0.008). Non-diabetics operated on in 1992–96 compared to those operated on in 1987–91 had a significantly lower combined permanent stroke and death rate (3.7% vs. 5.7% p =0.05), a difference not found in diabetics (6.3% for 1987–92 and 6.8% for 1992–96 Conclusions: diabetics had both a higher 30-day and 1-year mortality after CEA compared to non-diabetics, mainly because of cardiac complications. However, postoperative neurologic morbidity did not differ. Copyright 1999 W.B. Saunders Company Ltd
Databáze: Supplemental Index
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