Race as a predictor of delay from diagnosis to endarterectomy in clinically significant carotid stenosis

Journal of Vascular Surgery
Eric S WiseColleen M Brophy

Abstract

Prompt carotid endarterectomy (CEA) in clinically significant carotid stenosis is important in the prevention of neurologic sequelae. The greatest benefit from surgery is obtained by prompt revascularization on diagnosis. It has been demonstrated that black patients both receive CEA less frequently than white patients do and experience worse postoperative outcomes. We sought to test our hypothesis that black race is an independent risk factor for a prolonged time from sonographic diagnosis of carotid stenosis warranting surgery to the day of operation (TDO). From 1998 to 2013 at a single institution, 166 CEA patients were retrospectively reviewed using Synthetic Derivative, a de-identified electronic medical record. Factors potentially affecting TDO, including demographics, preoperative cardiac stress testing, degree of stenosis, smoking status, and comorbidities, were noted. Multivariate analysis was performed on variables that trended with prolonged TDO on univariate analysis (P < .10) to determine independent (P < .05) predictors of TDO. Subgroup analyses were further performed on the symptomatic and asymptomatic stenosis cohorts. There were 32 black patients and 134 white patients studied; the mean TDO was 78 ± 17 days vs 3...Continue Reading

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Citations

Dec 1, 2015·Annals of Vascular Surgery·Eric S WiseColleen M Brophy
Jan 10, 2020·Journal of Cardiothoracic and Vascular Anesthesia·Latha PanchapRobert S White
Feb 27, 2017·Stroke; a Journal of Cerebral Circulation·Carrington R WendellAlan B Zonderman

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