Evidence map›Paper›PMID 30690159›Full record

ArticleAnnals of vascular surgery2019

Early Carotid Endarterectomy after Acute Stroke Yields Excellent Outcomes: An Analysis of the Procedure-Targeted ACS-NSQIP.

Eddie Blay, Yetunde Balogun, Michael J Nooromid, Mark K Eskandari

Open access · greenAbstract readComparative Study
In one paragraph

Article in Annals of vascular surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.0field-weighted citation impact, top 22% 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

1 citing paper in PubMed, 12 citations in OpenAlex.

  1. Article
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

4 authors at 2 institutions in 1 country.

Eddie BlaySurgical Outcomes and Quality Improvement Center (SOQIC), Department of Surgery and Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL; Department of Surgery, Temple University Hospital, Philadelphia, PA. Electronic address: archimedes3t@gmail.com.
Yetunde BalogunDepartment of Surgery, Temple University Hospital, Philadelphia, PA.
Michael J NooromidDivision of Vascular Surgery, Department of Surgery, Northwestern University, Chicago, IL.
Mark K EskandariDivision of Vascular Surgery, Department of Surgery, Northwestern University, Chicago, IL.
Northwestern University · USTemple University Hospital · US

Funding

Vascular Surgery Scientist Training ProgramT32HL094293 · NHLBI · NORTHWESTERN UNIVERSITY AT CHICAGO · PI ESKANDARI, MARK K · 2009 to 2023
$4.0M
NHLBI NIH HHS T32 HL094293
6 · The paper itself

Abstract

backgroundRecurrent ischemic events have been associated with delayed carotid endarterectomy (CEA) for patients who present with acute strokes. As such, earlier intervention has been advocated to preserve cerebral function and expedient rehabilitation. We sought to determine the differences in 30-day postoperative major adverse clinical events (MACEs) for patients who undergo early (≤7 days) and delayed (>7 days) CEA after acute stroke.

methodsOur sample consisted of patients captured in the CEA-targeted American College of Surgeons National Surgical Quality Improvement Program data set between 2011 and 2015. The primary outcome was 30-day postoperative MACEs (death, stroke, or myocardial infarction [MI]). Differences in postoperative MACEs were determined between early and delayed CEA treatment. In addition, multivariable analyses were done to determine the association between various patient factors and postoperative complications after CEA for patients who presented with acute strokes.

resultsA total of 3,427 patients were identified who underwent CEA for acute stroke in the CEA-targeted files between 2011 and 2015. Overall, perioperative rates of 30-day death, stroke, or MI were 1.30% (n = 43), 2.74% (n = 94), and 0.96% (n = 33), respectively. There were no differences in 30-day postoperative death, stroke, or MI for early or delayed CEA after acute strokes. On multivariable analysis, independent predictors for postoperative MACEs in patients with acute stroke were age ≥80 years (OR 2.41; 95% CI [1.15-5.06]), preoperative beta-blocker use (OR 2.11; 95% CI [1.13-3.93]), and operative time > 150 min (OR 2.39; 95% CI [0.82-4.98]).

conclusionsThere are no differences in postoperative 30-day death, stroke, or MI in early and delayed CEA after an acute stroke. These results substantiate the recommendation for early (<7 days) CEA after acute strokes.

Indexed as

Endarterectomy, CarotidTime-to-TreatmentAgedAged, 80 and overBrain IschemiaCarotid StenosisClinical Decision-MakingDatabases, FactualFemaleHealth StatusHumansMaleMyocardial InfarctionRisk FactorsStrokeTime Factors

Identifiers

PMID30690159
PMCPMC6529250
OpenAlexW2914426445

What OpenQuestion holds

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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.