title: Audit of long-term mortality and morbidity outcomes for carotid endarterectomy.
abstract: There have been no Australian studies of long-term mortality status and cause of death after carotid endarterectomy (CEA) or, for survivors, quality-of-life. We first determined rate and cause of death for a cohort of patients four years after CEA. Surviving patients were surveyed to ascertain health status, using MOS SF-36. Of 238 patients who underwent CEA in our health service in 1995, 44 (18.5%) had died within four years. The majority of deaths (61.4%) were attributable to vascular causes. Of the surviving 162 patients (survey response fraction 90%), 10 (6.2%) subsequently had suffered a non-fatal stroke in the four years following their CEA. With respect to health status, Physical Functioning scores differed significantly by age (t = 2.65, df = 149, P = 0.01) as did Role Physical scores (t = 2.10, df = 142, P = 0.04). We conclude that patients undergoing CEA are at high risk of dying from vascular causes, inviting concerted efforts in discharge planning to co-ordinate optimal vascular risk factor management.
authors.affiliation: Division of Population Health, Central Sydney Area Health Service, School of Public Health, University of Sydney.
authors.forename: Sandy
authors.initials: S
authors.lastname: Middleton
authors.forename: Neil
authors.initials: N
authors.lastname: Donnelly
authors.forename: John
authors.initials: J
authors.lastname: Harris
authors.forename: Robert
authors.initials: R
authors.lastname: Lusby
authors.forename: Jeanette
authors.initials: J
authors.lastname: Ward
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D001026:Coronary Artery Bypass; D016894:Endarterectomy, Carotid / Q000009:adverse effects* / Q000401:mortality* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006779:Hospitals, Public; D006801:Humans; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D011788:Quality of Life; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D017741:Survivors / Q000523:psychology; D013995:Time; D016896:Treatment Outcome