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January 1, 2026JVS-Vascular InsightsOpen Access

High community distress is linked to increased long-term mortality and stroke but not short-term readmission risk in patients undergoing carotid endarterectomy

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Why the study?

It was unknown whether community socioeconomic distress is associated with carotid endarterectomy outcomes.

Does high community distress increase the risk of readmission, mortality, and stroke in patients undergoing carotid endarterectomy?

Population

33,909 patients undergoing CEA from the Vascular Quality Index database linked to Medicare claims

Comparison

High (DCI ≥40) vs low (DCI <40) community distress

Design

Registry-based retrospective cohort study

Follow-up

36-month

Discussion

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Member takes

Overview

High community distress signals elevated long-term risks after CEA; leaves open whether targeted interventions improve outcomes.

Structured PICO

Does high community distress increase the risk of readmission, mortality, and stroke in patients undergoing carotid endarterectomy?

P
Population
33,909 patients undergoing carotid endarterectomy (CEA) between 2015-2019 from the Vascular Quality Index database linked to Medicare claims, mean age 74.0 years, 92.6% White.
I
Intervention
High community distress (Distressed Communities Index [DCI] ≥40)
C
Comparator
Low community distress (Distressed Communities Index [DCI] <40)
O
Outcome
30- and 90-day readmission, 36-month mortality, and 36-month stroke riskhard clinical

High community distress is an independent risk factor for long-term mortality and stroke following carotid endarterectomy, highlighting the need for targeted interventions to address socioeconomic disparities.

Limitations

  • Lack of data for underrepresented minorities

Cite This Study

A 2026 study studied this question.

synapsesocial.com/papers/6a7ccd0ffecf32cfa0611ba7https://doi.org/10.1016/j.jvsvi.2026.100411
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Acute Kidney Injury as a Marker of Socioeconomic Vulnerability Following Carotid Endarterectomy2026
  2. 2Community level socioeconomic status association with surgical outcomes and resource utilisation in a regional cohort: a prospective registry analysis2019 · 58 citations
  3. 3Relationship Between Community-Level Distress and Cardiac Rehabilitation Participation, Facility Access, and Clinical Outcomes After Inpatient Coronary Revascularization2023 · 4 citations
  4. 4The Association between Distressed Community Index and Failure to Rescue after Cardiac Surgery among Medicare Beneficiaries2026 · 1 citations
  5. 5Poor long-term outcomes after carotid endarterectomy: a retrospective analysis of two portuguese centers2019 · 17 citations