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From the Departments of Neurology (Dr. Lanska), Preventive Medicine and Environmental Health (Dr. Lanska), Statistics (Dr. Kryscio), and the Sanders-Brown Center on Aging (Dr. Lanska), University of Kentucky Medical Center, Lexington; and the Neurology Service, Veterans Affairs Medical Center (Dr. Lanska), Lexington, KY.
Address correspondence and reprint requests to Dr. Lanska, Chief of Staff(11), Veterans Affairs Medical Center, 510 E. Veterans Street, Tomah, WI 54660.
Objectives: To determine population-based estimates of in-hospital mortality following carotid endarterectomy (CEA) and identify potential risk factors for in-hospital death.
Methods: Data from the Healthcare Cost and Utilization Project (HCUP-3) were analyzed for the year 1993. Nationally representative estimates of risk were calculated by age, sex, race, income, census region, hospital location (urban versus rural), teaching status of hospital, number of hospital beds, hospital ownership, third-party payer, principal procedure, and presence of surgical complications. Multivariate models were developed using stepwise logistic regression and a logit model fit by generalized estimating equations.
Results: There were 228 deaths among 18,510 CEAs performed in 17 states of the United States in 1993, yielding an estimated in-hospital mortality rate of 1.2%. Multivariate analysis showed that age, principal procedure, and presence of any surgical complication were significant predictors of in-hospital mortality increased with increasing age (from 0.9% in those younger than 65 years to 1.7% in those age 75 and older) and was markedly higher with CEA performed as a secondary procedure (6.1% versus 0.9%) or with any surgical complication (5.9% versus 0.9%).
Conclusions: Increasing age, CEA performed as a secondary procedure, and surgical complications are important predictors of in-hospital mortality following CEA.
Supported in part by the Department of Veterans Affairs (D.J.L.).
Received January 29, 1998. Accepted in final form April 16, 1998.
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