Patients at elevated risk of major adverse events following endarterectomy for asymptomatic carotid stenosis
| Autor: | Tiffany Wu, Steven G. Katz, Gabriel Akopian |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Databases Factual medicine.medical_treatment Carotid endarterectomy Risk Assessment Asymptomatic Angina Young Adult Postoperative Complications Risk Factors Internal medicine Odds Ratio medicine Humans Carotid Stenosis cardiovascular diseases Stroke Aged Endarterectomy Asymptomatic Diseases Aged 80 and over Endarterectomy Carotid business.industry General Medicine Perioperative Middle Aged medicine.disease Stenosis Logistic Models Treatment Outcome Cardiology Female Surgery medicine.symptom business |
| Zdroj: | The American Journal of Surgery. 209:1069-1073 |
| ISSN: | 0002-9610 |
| Popis: | Background Carotid endarterectomy (CEA) as treatment in patients with asymptomatic carotid stenosis is the subject of much debate. Methods The National Surgical Quality Improvement Program database from 2005 to 2012 was queried. Patients undergoing CEA for asymptomatic carotid stenosis were identified. Preoperative risk factors and patient demographics were compared using chi-square analysis and logistic regression to determine their relation with stroke and death. Results During an 8-year period, 24,211 CEAs performed for asymptomatic carotid stenosis were identified. Patients with dependent functional status (12.5%), recent myocardial infarction (6.3%), chronic heart failure (5.0%), hypoalbuminemia (4.8%), angina (4.1%), dialysis dependence (3.4%), steroid dependence (3.4%), chronic obstructive pulmonary disease (3.3%), and American Society of Anesthesiologists > 3 (3.2%) had a clinically significant increase in risk of stroke and death. Patients with none of the above risk factors had a stroke and death rate of 1.08%, which was significantly less than the overall stroke and death rate ( P Conclusions A high-risk subset of patients undergoing CEA for asymptomatic carotid stenosis can be identified. If patient selection is optimized and perioperative morbidity and mortality are minimized, CEA will continue to play an important role in stroke prevention for those with significant asymptomatic carotid stenosis. |
| Databáze: | OpenAIRE |
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