ArticleJournal of vascular surgery2015
Race as a predictor of delay from diagnosis to endarterectomy in clinically significant carotid stenosis.
Article in Journal of vascular surgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Disparities in Surgical Access: A Systematic Literature Review, Conceptual Model, and Evidence Map.Journal of the American College of Surgeons · 2019Pooled it
- Using natural language processing to extract carotid stenosis severity from clinical notes to create a nationwide veteran cohort.JVS-vascular insights · 2025Article
- Racial Differences in Adoption and Outcomes of Transcarotid Artery Revascularization among High-Risk Adults with Carotid Artery Stenosis.Annals of vascular surgery · 2025Article
- A Review of Healthcare Disparities Relevant to Interventional Radiology.Seminars in interventional radiology · 2023Review
- Inequities in surgical outcomes by race and sex in the United States: retrospective cohort study.BMJ (Clinical research ed.) · 2023Article
- Conditional Vasospasm-Free Survival Following Aneurysmal Subarachnoid Hemorrhage.Neurocritical care · 2022Article
- The impact of the ban on elective surgery in New York City during the coronavirus outbreak on gynecologic oncology patient care.Gynecologic oncology reports · 2022Article
- Race and sex-based disparities associated with carotid endarterectomy in the Atherosclerosis Risk in Communities (ARIC) study.Atherosclerosis · 2020Article
- The impact of race on outcomes after carotid endarterectomy in the United States.Journal of vascular surgery · 2018Article
- Distributions of Subclinical Cardiovascular Disease in a Socioeconomically and Racially Diverse Sample.Stroke · 2017Article
- Preoperative Predictors of 30-Day Mortality and Prolonged Length of Stay after Above-Knee Amputation.Annals of vascular surgery · 2016Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
objectivePrompt carotid endarterectomy (CEA) in clinically significant carotid stenosis is important in the prevention of neurologic sequelae. The greatest benefit from surgery is obtained by prompt revascularization on diagnosis. It has been demonstrated that black patients both receive CEA less frequently than white patients do and experience worse postoperative outcomes. We sought to test our hypothesis that black race is an independent risk factor for a prolonged time from sonographic diagnosis of carotid stenosis warranting surgery to the day of operation (TDO).
methodsFrom 1998 to 2013 at a single institution, 166 CEA patients were retrospectively reviewed using Synthetic Derivative, a de-identified electronic medical record. Factors potentially affecting TDO, including demographics, preoperative cardiac stress testing, degree of stenosis, smoking status, and comorbidities, were noted. Multivariate analysis was performed on variables that trended with prolonged TDO on univariate analysis (P < .10) to determine independent (P < .05) predictors of TDO. Subgroup analyses were further performed on the symptomatic and asymptomatic stenosis cohorts.
resultsThere were 32 black patients and 134 white patients studied; the mean TDO was 78 ± 17 days vs 33 ± 3 days, respectively (P < .001). In addition to the need for preoperative cardiac stress testing, black race was the only variable that demonstrated a trend with (P < .10) or was an independent risk factor for (P < .05) prolonged TDO among all patients (B = 42 days; P < .001) and within the symptomatic (B = 35 days; P = .08) and asymptomatic (B = 35 days; P = .003) cohorts. On Kaplan-Meier analysis, black patients in each stratum of symptomatology (all, symptomatic, and asymptomatic patients) experienced prolonged TDO (log-rank, P < .03 for all three groups).
conclusionsBlack race is a risk factor for a temporal delay in CEA for carotid stenosis. Awareness of this disparity may help surgeons avoid undesirable delays in operation for their black patients.
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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.