Carotid endarterectomy in the elderly: are the patient characteristics, the early outcome, and the predictors the same as those in younger patients?
BACKGROUND
The study was conducted to detect possible differences in patient characteristics, in early outcome, and in predictors for 30-day combined stroke and death rate between younger and older patients undergoing CEA.


METHODS
Between March 1988 and November 2005, we recorded prospectively the data from every patient who underwent carotid artery surgery. Cardiovascular risk factors, comorbidities, anesthetic and surgical techniques, outcome, and survival were reviewed and compared between <75 age and >or=75 age group.


RESULTS
We performed 1028 procedures in 742 patient. A total of 286 carotid endarterectomies were done in 213 patients 75 years or older. The number of cardiovascular risk factors per patient decreased with age. The risk factors tobacco use, hyperlipidemia, and the combination tobacco, hypertension, and hyperlipidemia were predominant in the younger group. Hypertension as only risk factor and the combination hypertension and hyperlipidemia were more present in the older group. The perioperative combined minor and major stroke and death rate was 2.8% in both groups. Attendant predictors for adverse outcome in the >or=75 age group were female sex and the combination of the risk factors diabetes, tobacco use, and hypertension.


CONCLUSIONS
The type, the number, and the combinations of cardiovascular risk factors and the predictors for adverse outcome are different in the 2 age groups. Our observations indicate that people 75 years or older with small number of cardiovascular risk factors can undergo CEA with the same risk of perioperative stroke and death as the younger patients.
Debing
Erik
E
Department of Vascular Surgery, Academic Hospital, Free University of Brussels, Brussels, B-1090 Belgium. erik.debing@az.vub.ac.be <erik.debing@az.vub.ac.be>
Van den Brande
Pierre
P
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology; D002318:Cardiovascular Diseases / Q000453:epidemiology; D016893:Carotid Stenosis / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D015897:Comorbidity; D016894:Endarterectomy, Carotid / Q000009:adverse effects / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D020521:Stroke / Q000209:etiology / Q000503:physiopathology; D014029:Tobacco Use Disorder / Q000453:epidemiology