Key result
Carotid endarterectomy demonstrated a 0.5% mortality rate and a 1% stroke rate, with higher rates of mortality, stroke, and costs observed at low-volume hospitals.
Why the study?
What are the contemporary perioperative outcomes, length of stay, and costs associated with carotid endarterectomy?
Observational (n=14,095)
Yes
What are the contemporary perioperative outcomes, length of stay, and costs associated with carotid endarterectomy?
Modern carotid endarterectomy is associated with very low perioperative mortality (0.5%) and stroke (1%) rates, alongside declining lengths of stay.
Supports selective referral to high-volume centers; leaves open whether regionalization improves outcomes in contemporary practice.
Many prospective, randomized clinical trials evaluating the safety and efficacy of carotid endarterectomy (CEA) versus medical management in the prevention of ischemic stroke were performed in the 1990s. Clinical trials are underway that will compare CEA outcomes to carotid stenting; however, relatively few studies have examined the outcomes of modern CEA. The purpose of this report is to examine current outcomes of CEA and evaluate hospital costs and length of stay. Statewide results were collected for all hospitals, except Veterans Administration hospitals, by Virginia Health Information (VHI). Data for the years 1997-2001 were evaluated, and data were based on the All Patient Refined Diagnostic Related Group (APR-DRG; 3M Company). A total of 14,095 CEAs were performed in a 5-year period. The mortality of patients undergoing CEA was 0.5 per cent. The stroke rate was 1 per cent overall and decreased each year of the study. Mean and median lengths of hospital stay were 3 and 2 days, respectively. Length of stay decreased over the course of this study. Mean and median hospital costs were 14,331 dollars and 11,268 dollars. Higher rates of mortality and stroke and higher costs were observed at low-volume hospitals. The need for CEA is substantial. CEA is safe and inexpensive. The data presented here demonstrates continued refinement in CEA, leading to a very low rate of perioperative adverse events, declining lengths of stay, and low hospital costs.
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Harthun et al. (2005) conducted an observational in Carotid stenosis (n=14,095). Carotid endarterectomy was evaluated on Mortality. Carotid endarterectomy demonstrated a 0.5% mortality rate and a 1% stroke rate, with higher rates of mortality, stroke, and costs observed at low-volume hospitals.
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