Community hospital carotid endarterectomy in patients over age 75.
We compared the prevalence of stroke and death in 133 patients aged 75 and older in whom 170 carotid endarterectomies were performed with that in 501 patients less than age 75 in whom 640 carotid endarterectomies were performed. There were three strokes (2%) in patients aged 75 and older and nine strokes (1%) in younger patients (p = 0.7). There were 8 deaths (5%) in patients aged 75 and older and 14 deaths (2%) in younger patients (p = 0.1). After controlling for the possible confounding effects of diabetes, prior stroke, history of angina, prior carotid artery disease, previous vascular surgery, history of myocardial infarction, preoperative hypertension requiring medication, and female gender, a logistic regression model showed that patients aged 75 and older were no more likely to have a stroke or death than patients under age 75. We conclude that age alone is not a contraindication to the safe performance of carotid endarterectomy in the community hospital.
Maxwell
J G
JG
Department of Surgery, University of North Carolina School of Medicine, Chapel Hill.
Rutherford
E J
EJ
Covington
D L
DL
Churchill
P
P
Patrick
R D
RD
Scott
C
C
Clancy
T V
TV
D000367:Age Factors; D000368:Aged; D002339:Carotid Arteries / Q000601:surgery*; D002561:Cerebrovascular Disorders / Q000453:epidemiology*; D004691:Endarterectomy / Q000401:mortality* / Q000592:standards; D005260:Female; D006746:Hospital Bed Capacity, 500 and over; D006764:Hospitals, Community / Q000706:statistics & numerical data*; D006801:Humans; D002546:Ischemic Attack, Transient / Q000401:mortality / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D009657:North Carolina; D015995:Prevalence; D012307:Risk Factors