Audit of long-term mortality and morbidity outcomes for carotid endarterectomy

• Published in: Australian health review Vol. 25; no. 4; pp. 81 - 91
• Main Authors: Middleton, Sandy, Donnelly, Neil, Harris, John, Lusby, Robert, Ward, Jeanette
• Format: Journal Article
• Language: English
• Published: Australia 01-01-2002
• Subjects: Aged; Aged, 80 and over; Comorbidity; Coronary Artery Bypass; Endarterectomy, Carotid - adverse effects; Endarterectomy, Carotid - mortality; Endarterectomy, Carotid - psychology; Female; Follow-Up Studies; Health administration; Health Status; Hospitals, Public; Humans; Male; Middle Aged; New South Wales - epidemiology; Quality of Life; Risk Factors; Stroke - epidemiology; Stroke - etiology; Stroke - prevention & control; Surveys and Questionnaires; Survival Analysis; Survivors - psychology; Time; Treatment Outcome; New South Wales
• ISSN: 0156-5788
• DOI: 10.1071/AH020081

There have been no Australian studies of long-term mortality status and cause of death after carotid endarterectomy (CEA) or, for survivors, quality-of-life. We first determined rate and cause of death for a cohort of patients four years after CEA. Surviving patients were surveyed to ascertain health status, using MOS SF-36. Of 238 patients who underwent CEA in our health service in 1995, 44 (18.5%) had died within four years. The majority of deaths (61.4%) were attributable to vascular causes. Of the surviving 162 patients (survey response fraction 90%), 10 (6.2%) subsequently had suffered a non-fatal stroke in the four years following their CEA. With respect to health status, Physical Functioning scores differed significantly by age (t = 2.65, df = 149, P = 0.01) as did Role Physical scores (t = 2.10, df = 142, P = 0.04). We conclude that patients undergoing CEA are at high risk of dying from vascular causes, inviting concerted efforts in discharge planning to co-ordinate optimal vascular risk factor management. (author abstract)