Evidence map›Paper›PMID 39572277›Full record

ArticleAmerican journal of surgery2025

A standardized carotid endarterectomy care pathway is associated with lower ICU admission rates and a significant reduction in hospital charges.

Holly Grunebach, Timothy Madeira, Sanuja Bose, Courtenay Holscher, Roberto G Aru, Christopher J Abularrage, James H Black, Ying Wei Lum, Bruce A Perler, Caitlin W Hicks

Abstract read
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In one paragraph

Article in American journal of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Observational
  2. 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

10 authors.

Holly GrunebachThe Johns Hopkins Hospital, Baltimore, MD, USA. Electronic address: hgruneb1@jh.edu.
Timothy MadeiraThe Johns Hopkins Hospital, Baltimore, MD, USA.
Sanuja BoseDivision of Vascular Surgery and Endovascular Therapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Courtenay HolscherJohns Hopkins Bayview Medical Center, 4940 Eastern Avenue, Baltimore, MD, 21224, USA.
Roberto G AruThomas Jefferson University Hospital, 833 Chestnut st. Ste. 703, Philadelphia, PA, 19107, USA.
Christopher J AbularrageDivision of Vascular Surgery and Endovascular Therapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
James H BlackDivision of Vascular Surgery and Endovascular Therapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Ying Wei LumDivision of Vascular Surgery and Endovascular Therapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Bruce A PerlerDivision of Vascular Surgery and Endovascular Therapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Caitlin W HicksDivision of Vascular Surgery and Endovascular Therapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: chicks11@jhmi.edu.

Funding

Risk Factors and Outcomes Associated with Late-Life Diabetic Peripheral NeuropathyK23DK124515 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI HICKS, CAITLIN WHITNEY · 2020 to 2024
$898k
NIDDK NIH HHS K23 DK124515
6 · The paper itself

Abstract

backgroundThis study investigated the outcomes before and after initiation of a postoperative care pathway for carotid endarterectomy (CEA) patients.

methodsA CEA pathway was developed with stakeholders. We compared in-hospital outcomes and charges (USD) for patients undergoing CEA 18 months before (11/2019-04/2021) vs. after (05/2021-11/2022) implementation.

results149 patients (mean age 70.2 ​± ​10.9 years, 60.4 ​% male, 75.7 ​% white) underwent CEA (83 pre-initiative, 66 post-initiative). There was significant reduction in intensive care unit (ICU) care (90.4 ​% vs.46.2 ​%; P ​< ​0.001) but no changes in stroke (3.6 ​% vs. 0 ​%), death (0 ​% vs. 0 ​%), or median length-of stay (1.0 vs. 1.0 days) following implementation (all, P ​> ​0.12). After risk adjustment, the pathway was associated with charge reductions of $1631/patient/day (95%CI -$3,008, -$254).

conclusionsInitiation of a CEA pathway was associated with lower ICU rates and reduction in hospital charges without compromising patient outcomes.

Indexed as

Critical PathwaysEndarterectomy, CarotidHospital ChargesIntensive Care UnitsAgedCarotid StenosisFemaleHumansLength of StayMaleMiddle AgedRetrospective StudiesCare pathwayCarotid endarterectomyIntensive care unitIntermediate care unit

Identifiers

PMID39572277
PMCPMC11702289

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Registered trials

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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.