Document Detail


Carotid endarterectomy: a ten-year analysis of outcome and cost of treatment.
MedLine Citation:
PMID:  2243409     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Between 1978 and 1988, 215 patients with an average age of 67 years, underwent 246 carotid endarterectomies. Two hundred ten (85.4%) patients were symptomatic, and 36 (14.6%) were asymptomatic. Six patients (2.4%) had a postoperative stroke, and all had immediate reoperation. One of these patients died (30 day mortality rate, 0.4% for the series), and two (0.8%) recovered completely, whereas three (1.2%) had a mild permanent neurologic deficit. Two patients (0.8%) had nonfatal myocardial infarction. Mean follow-up of 42.2 months (range, 1 to 126 months) was achieved. At 5 and 8 years actuarial survival rates of 82% and 66% and stroke-free survival rates of 67% and 37% were observed. Actuarial stroke free rates of 90% at 5 and 8 years were noted. By introducing and observing guidelines that required preoperative study of most clearly defined classes of patients before admission for surgical treatment, the average length of stay for carotid endarterectomy was lowered from 9.5 days in the first 5 years of the study to 5.8 days in the second 5 years (p = 0.001). Average hospital charges, expressed in constant dollars, decreased from $3113 in the first 5 years to $2620 in the second 5 years (p = 0.02) despite an 88% inflationary increase in medical consumer price index. This experience shows that the length of hospitalization of patients with carotid endarterectomy can be reduced and the cost of admission lowered without untoward effect on perioperative morbidity and mortality rates.
Authors:
B S Maini; T F Mullins; J Catlin; P O'Mara
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  12     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  1990 Dec 
Date Detail:
Created Date:  1991-01-03     Completed Date:  1991-01-03     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  732-9; discussion 739-40     Citation Subset:  IM    
Affiliation:
Division of General and Vascular Surgery, Fallon Clinic, Worcester, MA 01606.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Carotid Arteries / surgery*
Carotid Artery Diseases / complications,  economics,  mortality,  surgery
Costs and Cost Analysis / economics
Endarterectomy / adverse effects*,  economics,  mortality
Fees and Charges
Female
Follow-Up Studies
Humans
Length of Stay / economics
Life Tables
Male
Massachusetts
Middle Aged

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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