Evidence map›Paper›PMID 27236090›Full record

ArticleAnnals of vascular surgery2016

Relationships between 2-Year Survival, Costs, and Outcomes following Carotid Endarterectomy in Asymptomatic Patients in the Vascular Quality Initiative.

Jessica B Wallaert, Karina A Newhall, Bjoern D Suckow, Benjamin S Brooke, Min Zhang, Adrienne E Farber, Donald Likosky, Philip P Goodney, Vascular Quality Initiative

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of vascular surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Jessica B WallaertDepartment of Surgery, Dartmouth Hitchcock Medical Center, Lebanon, NH. Electronic address: Jessica.B.Wallaert@hitchcock.org.
Karina A NewhallDepartment of Surgery, Dartmouth Hitchcock Medical Center, Lebanon, NH.
Bjoern D SuckowDepartment of Surgery, Dartmouth Hitchcock Medical Center, Lebanon, NH.
Benjamin S BrookeDepartment of Surgery, University of Utah Health Care, Salt Lake City, UT.
Min ZhangDepartment of BIostatistics, The University of Michigan, Ann Arbor, MD.
Adrienne E FarberThe Dartmouth Institute, Hanover, NH.
Donald LikoskyDepartment of Cardiac Surgery, The University of Michigan, Ann Arbor, MD.
Philip P GoodneyDepartment of Surgery, Dartmouth Hitchcock Medical Center, Lebanon, NH.
Vascular Quality Initiative
Dartmouth–Hitchcock Medical Center · USUniversity of Michigan · USUniversity of Utah Health Care · US

Funding

Creating National Surveillance Infrastructure for Priority Medical DevicesU01FD005478 · FDA · WEILL MEDICAL COLL OF CORNELL UNIV · PI SEDRAKYAN, ART · 2015 to 2019
$6.5M
Understanding Variation in Treatment Intensity with Lower Extremity PADK08HL105676 · NHLBI · DARTMOUTH COLLEGE · PI GOODNEY, PHILIP P · 2010 to 2014
$700k
AHRQ HHS R21 HS021581FDA HHS U01 FD005478NHLBI NIH HHS K08 HL105676
6 · The paper itself

Abstract

backgroundCarotid endarterectomy (CEA) for asymptomatic patients with limited life expectancy may not be beneficial or cost-effective. The purpose of this study was to examine relationships among survival, outcomes, and costs within 2 years following CEA among asymptomatic patients.

methodsProspectively collected data from 3097 patients undergoing CEA for asymptomatic disease from Vascular Quality Initiative VQI registry were linked to Medicare. Models were used to identify predictors of 2-year mortality following CEA. Patients were classified as low, medium, or high risk of death based on this model. Next, we examined costs related to cerebrovascular care, occurrence of stroke, rehospitalization, and reintervention within 2 years following CEA across risk strata.

resultsOverall, 2-year mortality was 6.7%. Age, diabetes, smoking, congestive heart failure (CHF), chronic obstructive pulmonary disease, renal insufficiency, absence of statin use, and contralateral internal carotid artery (ICA) stenosis were independently associated with a higher risk of death following CEA. In-hospital costs averaged $7500 among patients defined as low risk for death, and exceeded $10,800 among high risk patients. Although long-term costs related to cerebrovascular disease were 2 times higher in patients deemed high risk for death compared with low risk patents ($17,800 vs. $8800, P = 0.001), high risk of death was not independently associated with a high probability of high cost. Predictors of high cost at 2 years were severe contralateral ICA stenosis, dialysis dependence, and American Society for Anesthesia Class 4. Both statin use and CHF were protective of high cost.

conclusionsGreater than 90% of patients undergoing CEA live long enough to realize the benefits of their procedure. Moreover, the long-term costs are supported by the effectiveness of this procedure at all levels of patient risk.

Indexed as

Health Care CostsAgedAged, 80 and overAsymptomatic DiseasesCarotid StenosisEndarterectomy, CarotidFemaleHumansKaplan-Meier EstimateMaleMedicareProportional Hazards ModelsProspective StudiesQuality ImprovementQuality Indicators, Health CareRegistries

Identifiers

PMID27236090
PMCPMC6615062
OpenAlexW2397293743

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.