ArticleStroke2012
Carotid endarterectomy in asymptomatic patients with limited life expectancy.
Article in Stroke, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
What it found
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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.
The trial behind it
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
9 citing papers in PubMed, 25 citations in OpenAlex.
- Frailty as measured by the Risk Analysis Index is associated with long-term death after carotid endarterectomy.Journal of vascular surgery · 2020Article
- Trends in Low-Value Carotid Imaging in the Veterans Health Administration From 2007 to 2016.JAMA network open · 2020Article
- An Accumulated Deficits Model Predicts Perioperative and Long-term Adverse Events after Carotid Endarterectomy.Annals of vascular surgery · 2018Article
- Relationships between 2-Year Survival, Costs, and Outcomes following Carotid Endarterectomy in Asymptomatic Patients in the Vascular Quality Initiative.Annals of vascular surgery · 2016Article
- Physician specialty and variation in carotid revascularization technique selected for Medicare patients.Journal of vascular surgery · 2016Article
- Development and pilot feasibility study of a health information technology tool to calculate mortality risk for patients with asymptomatic carotid stenosis: the Carotid Risk Assessment Tool (CARAT).BMC medical informatics and decision making · 2015Article
- Asymptomatic carotid stenosis: immediate revascularization or watchful waiting?Current cardiology reports · 2014Review
- Optimal selection of asymptomatic patients for carotid endarterectomy based on predicted 5-year survival.Journal of vascular surgery · 2013Article
- Management of asymptomatic carotid artery stenosis.Current treatment options in cardiovascular medicine · 2013Article
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
background and purposeData from randomized trials assert that asymptomatic patients undergoing carotid endarterectomy (CEA) must live 3 to 5 years to realize the benefit of surgery. We examined how commonly CEA is performed among asymptomatic patients with limited life expectancy.
methodsWithin the American College of Surgeons National Quality Improvement Project we identified 8 conditions associated with limited life expectancy based on survival estimates using external sources. We then compared rates of 30-day stroke, death, and myocardial infarction after CEA between asymptomatic patients with and without life-limiting conditions.
resultsOf 12,631 CEAs performed in asymptomatic patients, 2525 (20.0%) were in patients with life-limiting conditions or diagnoses. The most common conditions were severe chronic obstructive pulmonary disease and American Society of Anesthesiologists Class IV designation. Patients with life-limiting conditions had significantly higher rates of perioperative complications, including stroke (1.8% versus 0.9%, P<0.001), death (1.4% versus 0.3%, P<0.001), and stroke/death (2.9% versus 1.1%, P<0.001). Even after adjustment for other comorbidities, patients with life-limiting conditions were nearly 3 times more likely to experience perioperative stroke or death than those without these conditions (OR, 2.8; 95% CI, 2.1-3.8; P<0.001).
conclusionCEA is performed commonly in asymptomatic patients with life-limiting conditions. Given the high rates of postoperative stroke/death in these patients as well as their limited life expectancy, the net benefit of CEA in this population remains uncertain. Health policy research examining the role of CEA in asymptomatic patients with life-limiting conditions is necessary and may serve as a potential source for significant healthcare savings in the future.
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What OpenQuestion holds
Registered trials
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.