This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Risk modelling for carotid endarterectomy. BJS 2001; 88: 622-622.
Published: 6th December 2002
Authors: G. Kuhan, E. Gardiner, A. Abidia, I. Chetter, P. Renwick, B. F. Johnson et al.
Background
A 30‐day stroke or death rate of 3–10 per cent has been reported in patients undergoing carotid endarterectomy (CEA). The aim of this study was to identify the risk factors that influenced the outcome and to develop a logistic regression model that can aid in the comparative audit of CEA.
Method
Some 836 CEAs performed by four vascular surgeons from 1992 to 1999 were analysed. The median age of the population was 69 (range 38–86) years, and the male: female ratio was 1·6. Multiple logistic regression was used to model the effect of 15 risk factors on the 30‐day stroke and death rate. The outcome after risk adjustment was compared for four surgeons and two vascular units.
Results
The overall 30‐day stroke and death rate was 3·9 per cent. Regression modelling identified heart disease, diabetes and stroke at presentation as significant risk factors. A risk score of 1 was assigned to each of these risk factors to produce a logistic regression equation (where P is the probability of 30‐day stroke or death):
Conclusion
Multiple logistic regression models can successfully identify patients at higher risk from CEA, and aid in the comparative audit of surgeons and vascular units. © 2001 British Journal of Surgery Society Ltd
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