Comparison of outcomes in women and men following carotid interventions in the Washington state's Vascular Interventional Surgical Care and Outcomes Assessment Program
| Autor: | Mark H. Meissner, Surgical Care, Sara Khor, Daiva Nevidomskyte, David R. Flum, Gale L. Tang, Susanna H. Shin, Outcomes Assessment Program (Scoap) Collaborative, Thomas S. Hatsukami, Sherene Shalhub |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Carotid Artery Diseases
Male Washington medicine.medical_specialty Time Factors Databases Factual medicine.medical_treatment Psychological intervention Carotid endarterectomy Disease 030204 cardiovascular system & hematology Risk Assessment 03 medical and health sciences Sex Factors 0302 clinical medicine Risk Factors Internal medicine medicine Humans Registries 030212 general & internal medicine Stroke Aged Retrospective Studies Aged 80 and over Endarterectomy Carotid business.industry Surgical care Endovascular Procedures Middle Aged medicine.disease Treatment Outcome Cohort Female Surgery Registry data Carotid stenting Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Vascular Surgery. 69:1121-1128 |
| ISSN: | 0741-5214 |
| DOI: | 10.1016/j.jvs.2018.08.152 |
| Popis: | The benefit for carotid endarterectomy (CEA) to prevent a potential stroke has been shown to be less beneficial for women compared with men and the risk of carotid stenting (CAS) is higher in women than men. We hypothesized that a community-based Washington state registry data would also reveal increased morbidity and mortality for women undergoing carotid interventions.Deidentified data for CEA and CAS between 2010 and 2015 were obtained from 19 hospitals participating in the Washington State Vascular-Interventional Surgical Care and Outcomes Assessment Program. Data analysis compared in-hospital composite outcome of stroke and mortality from CEA and CAS between women and men.Over the study period, 3704 individuals underwent CEA (n = 2759; 49.5% symptomatic) and CAS (n = 945; 60.9% symptomatic). Women accounted for 39.5% of the cohort. Women were slightly younger than men (70.0 ± 10.2 vs 71.0 ± 9.6 years respectively; P .01), less likely to be smokers (70.1% vs 75.6%; P .01), and less likely to have a diagnosis of coronary artery disease (32.9% vs 46.5%; P .01). Fewer women underwent CEA for symptomatic carotid disease (46.1% vs 51.8%; P .01). There were no statistically significant differences in the postoperative in-hospital stroke and mortality among women and men undergoing CEA (asymptomatic, 0.8% vs 1.4% [P = .36]; symptomatic, 1.8% vs 2.2% [P = .58]) and CAS (asymptomatic, 1.4% vs 2.2% [P = .56]; symptomatic, 4.6% vs 2.5% [P = .18]). Hospital duration of stay and discharge disposition were similar for women and men. A subanalysis of the octogenarian cohort undergoing CAS demonstrated a substantial increase in-hospital stroke and mortality among women and men (11.6% [CAS] vs 2.2% [CEA]; P = .024).In the Washington state Vascular-Interventional Surgical Care and Outcomes Assessment Program registry, hospital composite outcome of stroke and mortality following carotid interventions from 2010 to 2015 were noted to be similar for women and men. The notable exception to this finding was observed in subcohort of women undergoing CAS for symptomatic carotid disease at age 80 years or older. These findings should be taken into account when risk stratifying patients for carotid interventions. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|