Indications for intensive care unit care after carotid endarterectomy

To describe the complications of carotid endarterectomy and the interventions performed in the intensive care unit (ICU) after carotid endarterectomy. To identify preoperative and recovery room (RR) risk markers for these complications and interventions. A retrospective case study. The ICU of a univ...

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Bibliographic Details
Published in:Canadian Journal of Surgery 1996-04, Vol.39 (2), p.99-104
Main Author: Passerini, L
Format: Article
Language:English
Subjects:
Aged
Critical Care - utilization
Endarterectomy, Carotid
Female
Humans
Incidence
Intensive Care Units - utilization
Male
Original
Outcome Assessment (Health Care)
Patient Admission
Postoperative Complications - epidemiology
Postoperative Complications - therapy
Recovery Room
Retrospective Studies
Risk Factors
Severity of Illness Index
Time Factors
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Summary:To describe the complications of carotid endarterectomy and the interventions performed in the intensive care unit (ICU) after carotid endarterectomy. To identify preoperative and recovery room (RR) risk markers for these complications and interventions. A retrospective case study. The ICU of a university hospital. One hundred and one patients who required carotid endarterectomy over a 15-month period. Carotid endarterectomy (bilateral procedures in 11 patients). Demographic data including Goldman's cardiac risk index and the therapeutic intervention scoring system (TISS) score to measure the risk of complications. Most of interventions conducted in the RR and ICU were to control high blood pressure. In the RR, three patients experienced a neurologic event, one patient was reintubated for vocal cord paralysis and one had electrocardiographic abnormalities. Overall, 5 of the 101 patients had neurologic complications and 2 suffered a myocardial infarction. Two patients died, one as a result of a massive stroke and the other of myocardial infarction with cardiogenic shock. The mean (and standard deviation) TISS. score in the ICU was 12.6 (3.8). Analysis of all events in the RR was not predictive of events in the ICU. However, the absence of major complications in the RR had a negative predictive value of 97%. The decision to admit patients to the ICU after carotid endarterectomy should be based on major complications occurring in the RR. A low TISS score and low incidence of complications does not warrant routine admission.
ISSN:0008-428X
1488-2310