Abstract Details

Title Risk Index for Predicting In-Hospital Complications for Patients Undergoing Carotid Endarterectomy (CEA)

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P06 - (-)

Poster/Presentation
Number 243

Objective

Background BACKGROUND: Very few studies have developed risk indices derived from statistical models to predict inhospital outcomes of CEA.

Design/Methods DESIGN/METHODS: We analyzed the data from the Nationwide Inpatient Sample (NIS) which is representative of all admissions in the United States from 2005-2009. The primary end point was occurrence of stroke, cardiac complications, or death during the post procedural period. Multivariate logistic regression was performed to identify the effect of clinical and demographic factors associated with the composite end point. Covariates included in the logistic regression were patient's age, gender, co-morbid conditions including hypertension, diabetes mellitus , chronic lung disease, congestive heart failure and renal failure; symptom status and atrial fibrillation. Data from 2005-2006 (study period-1) was used to derive the risk index score while data from 2007-2009 (study period-2) was used for validation model.

Results RESULTS: A total 120,633 patients with mean age 71.1±9.5 and 42.4% females underwent CEA for treatment carotid artery disease during the study period. Multivariate correlates of the composite outcome were (odds ratio, P value) as follows: age?70 (1.15, 0.013), atrial fibrillation (3.18,<.0001), congestive heart failure (1.81, <.0001), cigarette smoking (1.64,<.0001), symptomatic status (1.87,<.001) and chronic renal failure (1.64, <.0001). Patients with higher scores on complication index were more likely to have peri-opertive complications (p<0.0001). Patients with scores 2-3 had higher composite complications (odd ratio 2.5, 95% confidence interval 2.3-2.7), scores 3-4 (OR 4.8, 95%C.I. 4.3- 5.4) and scores of ?5 (OR 7.4, 95%C.I. 6.4-8.5) as compared to scores ?1.

Conclusions CONCLUSIONS: Complication risk index can help us identifying patients who are at an increased risk for adverse outcomes in general practice. Prospective studies are required to identify high risk patients with carotid stenosis undergoing revascularization.

Authors/Disclosures
Saqib A. Chaudhry, MD PRESENTER	Dr. Chaudhry has nothing to disclose.
Syed I. Hussain, MD (Cleveland Clinic Abu Dhabi)	Dr. Hussain has nothing to disclose.
	No disclosure on file
Stewart A. Factor, DO, FAAN (Emory University School of Medicine)	Dr. Factor has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Neurocrine. Dr. Factor has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Factor has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Takeda. The institution of Dr. Factor has received research support from Biohaven. The institution of Dr. Factor has received research support from Neurocrine. The institution of Dr. Factor has received research support from Supernus. The institution of Dr. Factor has received research support from Sun Pharmaceuticals Advanced Research Company. The institution of Dr. Factor has received research support from Aspen. The institution of Dr. Factor has received research support from RHO. Dr. Factor has received publishing royalties from a publication relating to health care. Dr. Factor has received publishing royalties from a publication relating to health care. Dr. Factor has received publishing royalties from a publication relating to health care. Dr. Factor has received publishing royalties from a publication relating to health care.
Ameer Hassan, DO (Valley Baptist Medical Center)	Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Medtronic. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Stryker. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Penumbra. Dr. Hassan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Cerenovus. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Viz.ai. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Genentech. Dr. Hassan has received research support from GE Healthcare.
	No disclosure on file
Hamza I. Maqsood, MD (Dept of Neurology)	Dr. Qureshi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for AstraZeneca.

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