ArticleStroke2010
Predicting risk of perioperative death and stroke after carotid endarterectomy in asymptomatic patients: derivation and validation of a clinical risk score.
Article in Stroke, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 3 syntheses or guidelines pooled it, 69 citations in OpenAlex.
- External Validation of Risk Prediction Models to Improve Selection of Patients for Carotid Endarterectomy.Stroke · 2022Pooled it
- The comparative and added prognostic value of biomarkers to the Revised Cardiac Risk Index for preoperative prediction of major adverse cardiac events and all-cause mortality in patients who undergo noncardiac surgery.The Cochrane database of systematic reviews · 2021Pooled it
- Temporal trends in safety of carotid endarterectomy in asymptomatic patients: systematic review.Neurology · 2015Pooled it
- Combined risk modelling approach to identify the optimal carotid revascularisation approach.Stroke and vascular neurology · 2021Article
- Contemporary outcomes after carotid endarterectomy in high-risk anatomic and physiologic patients.Journal of vascular surgery · 2020Article
- Predictive Score of Adverse Events After Carotid Endarterectomy: The NSQIP Registry Carotid Endarterectomy Scale.Journal of the American Heart Association · 2019Article
- Risk Prediction Tools to Improve Patient Selection for Carotid Endarterectomy Among Patients With Asymptomatic Carotid Stenosis.JAMA surgery · 2019Article
- Comparison of outcomes after carotid endarterectomy between type 2 diabetic and non-diabetic patients with significant carotid stenosis.Cardiovascular diabetology · 2019Observational
- Migraine and risk of perioperative ischemic stroke and hospital readmission: hospital based registry study.BMJ (Clinical research ed.) · 2017Article
- Field Synopsis of the Role of Sex in Stroke Prediction Models.Journal of the American Heart Association · 2016Article
- [Prediction in cerebrovascular diseases].Der Nervenarzt · 2014Review
- Clinical prediction model suitable for assessing hospital quality for patients undergoing carotid endarterectomy.Journal of the American Heart Association · 2014Article
- Preoperative steroid use and the risk of infectious complications after neurosurgery.The Neurohospitalist · 2014Article
- Optimal selection of asymptomatic patients for carotid endarterectomy based on predicted 5-year survival.Journal of vascular surgery · 2013Article
- In-hospital versus postdischarge adverse events following carotid endarterectomy.Journal of vascular surgery · 2013Article
- Risk index for predicting perioperative stroke, myocardial infarction, or death risk in asymptomatic patients undergoing carotid endarterectomy.Journal of vascular surgery · 2013Article
- Comparison of carotid endarterectomy and stenting in real world practice using a regional quality improvement registry.Journal of vascular surgery · 2012Article
- Article
- When is a peri-procedural death iatrogenic in nature?Forensic science, medicine, and pathology · 2012Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
background and purposeNational guidelines on carotid endarterectomy (CEA) for asymptomatic patients state that the procedure should be performed with a ≤ 3% risk of perioperative death or stroke. We developed and validated a multivariate model of risk of death or stroke within 30 days of CEA for asymptomatic disease and a related clinical prediction rule.
methodsWe analyzed asymptomatic cases in a population-based cohort of CEAs performed in Medicare beneficiaries in New York State. Medical records were abstracted for sociodemographics, neurologic history, disease severity, diagnostic imaging data, comorbidities, and deaths and strokes within 30 days of surgery. We used multivariate logistic regression to identify independent predictors of perioperative death or stroke. The CEA-8 clinical risk score was derived from the final model.
resultsAmong the 6553 patients, the mean age was 74 years, 55% were male, 62% had coronary artery disease, and 22% had a history of distant stroke or transient ischemic attack. The perioperative rate of death or stroke was 3.0%. Multivariable predictors of perioperative events were female sex (odds ratio [OR] = 1.5; 95% CI, 1.1 to 1.9), nonwhite race (OR = 1.8; 95% CI, 1.1 to 2.9), severe disability (OR = 3.7; 95% CI, 1.8 to 7.7), congestive heart failure (OR = 1.6; 95% CI, 1.1 to 2.4), coronary artery disease (OR = 1.6; 95% CI, 1.2 to 2.2), valvular heart disease (OR = 1.5; 95% CI, 1.1 to 2.3), a distant history of stroke or transient ischemic attack (OR = 1.5; 95% CI, 1.1 to 2.0), and a nonoperated stenosis ≥ 50% (OR = 1.8; 95% CI, 1.3 to 2.3). The CEA-8 risk score stratified patients with a predicted probability of death or stroke rate from 0.6% to 9.6%.
conclusionsSeveral sociodemographic, neurologic severity, and comorbidity factors predicted the risk of perioperative death or stroke in asymptomatic patients. The CEA-8 risk score can help clinicians calculate a predicted probability of complications for an individual patient to help inform the decision about revascularization.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.