[Quality control in carotid surgery. Results from the carotid surgery records in Central region of Spain (1999-2000)].
OBJECTIVE
Evaluation of technique and results of carotid endarterectomy (CEA) in the central region in Spain and possible differences among the hospitals included. Study of factors predictors of complications.


METHODS
All CEAs performed in 9 hospitals in the central region in Spain (1999 2000). Registry design by a specific commission and contents selected by consensus. Voluntary participation. Ambispective study. Uni and multivariate statistical analysis (logistic regression).


RESULTS
576 procedures registered. Global mortality: 1.9%. 15 (2.7%) patients died or were severely handicapped. The selection of patients adjusted to expert s recommendations in 98%. Significant differences in technique and results were found among the hospital centres (>0,25). In the multivariate analysis, the risk factors associated with complications were: presence of preoperative symptoms (p= 0.006) small number of annual CEAs (p= 0.01), contralateral occlusion (RR= 4.7, p= 0.02) and use of shunt (RR= 6.1, p= 0.01).


CONCLUSIONS
Globally, both the selection of patients and the results obtained adjust to the accepted standards for this type of surgery. The patient s risk profile has had a greater influence on the results than the technique used. The mortality rate has been influenced by the low volume hospitals
Reina Gutiérrez
M T
MT
Hospital Clinico Universitario San Carlos, Madrid, España. angcva@hcsc.insalud.es
Arribas Díaz
A
A
Masegosa Medina
J A
JA
Porto Rodríguez
J
J
Serrano Hernando
F J
FJ
D002339:Carotid Arteries / Q000601:surgery*; D011786:Quality Control; D013030:Spain