A New Risk Index for Predicting Outcomes among Patients Undergoing Carotid Endarterectomy in Large Administrative Data Sets

Background We developed and validated a new index to provide risk adjustment and to predict in-hospital patient mortality and other outcomes in patients undergoing carotid endarterectomy (CEA). Methods The primary endpoint was occurrence of stroke, cardiac complications, or death during hospitalizat...

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Bibliographic Details
Published in:Journal of stroke and cerebrovascular diseases 2016-08, Vol.25 (8), p.1978-1983
Main Authors: Chaudhry, Saqib A., MD, Afzal, Mohammad R., MD, Kassab, Abdulkader, Hussain, Syed I., MD, Qureshi, Adnan I., MD
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Cardiovascular
carotid endarterectomy
Databases, Factual - statistics & numerical data
Endarterectomy, Carotid - adverse effects
Female
Heart Diseases - surgery
Hospital Mortality
Humans
Logistic Models
Male
Middle Aged
national database
Neurology
outcome prediction
Postoperative Complications - diagnosis
Predictive Value of Tests
Reproducibility of Results
Retrospective Studies
Risk Assessment - methods
Risk Factors
Risk index
ROC Curve
United States - epidemiology
validation study
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Summary:Background We developed and validated a new index to provide risk adjustment and to predict in-hospital patient mortality and other outcomes in patients undergoing carotid endarterectomy (CEA). Methods The primary endpoint was occurrence of stroke, cardiac complications, or death during hospitalization for CEA derived from the Nationwide Inpatient Sample. Multivariate logistic regression was performed to identify the effect of clinical and demographic factors on occurrence of the primary endpoint. Data from 2005 to 2006 (study period 1) were used to derive risk index score whereas data from 2007 to 2009 (study period 2) were used for validation of the risk index. Results A total of 120,633 patients with mean age in years [ ±SD] of 71.1[ ±9.5] (42.4% women) underwent CEA during the derivation period. The rate of occurrence of composite endpoint during study period 1 was 3.1%. Predictors of the composite endpoint were (odds ratio [OR], P value) as follows: age 70 years or older (1.15, .013 assigned 1 point), atrial fibrillation (3.18, 
ISSN:1052-3057
1532-8511
DOI:10.1016/j.jstrokecerebrovasdis.2016.01.023