A STATEWIDE, HOSPITAL-BASED ANALYSIS OF FREQUENCY AND OUTCOMES IN CAROTID ENDARTERECTOMY

BACKGROUND: For more than 40 years carotid endarterectomy (CE) has bee n used in the treatment of extracranial carotid disease for the preven tion of stroke, Recent prospective clinical trials have confirmed the benefit of CE for both symptomatic and asymptomatic patients, Our purp ose was to examine statewide trends in the numbers of CE over a 6-year time period and to evaluate outcomes, METHODS: Using data from the No rth Carolina Medical Database Commission (NCMDC) all CE procedures fro m 1988 to 1993 were identified, Numbers of CE were compared with the p opulation and hospital admissions, Variables of length of stay, hospit al charges, discharge disposition, and occurrence of stroke and death were analyzed. RESULTS: A total of 11,973 CE were performed in 6 years , Compared by admissions, population, and the proportion of elderly, t he number of CE increased yearly, The stroke rate was 1.7% and the dea th rate 1.2% for an overall in-hospital stroke plus mortality rate of only 2.7%. CONCLUSIONS: From a diverse group of hospitals and a large number of surgeons and patients, this hospital-based study documents t he acceptance and safety of CE in the treatment of extracranial caroti d disease. (C) 1997 by Excerpta Medica, Inc.