Waiting times for carotid endarterectomy in UK: observational study.
OBJECTIVE
To assess timeliness of carotid endarterectomy services in the United Kingdom.


METHODS
Observational study with follow-up to March 2008.


METHODS
UK hospitals performing carotid endarterectomy.


METHODS
UK surgeons undertaking carotid endarterectomy from December 2005 to December 2007.


METHODS
Provision and speed of delivery of appropriate assessments of patients; carotid endarterectomy and operative mortality; 30 day postoperative mortality.


RESULTS
240 (61% of those eligible) consultant surgeons took part from 102 (76%) hospitals and trusts. Of 9913 carotid endarterectomies recorded on hospital episode statistics, 5513 (56%) were included. Of the patients who underwent endarterectomy, 83% had a history of transient ischaemic attack or stroke. Of these recently symptomatic patients, 20% had their operation within two weeks of onset of symptoms and 30% waited more than 12 weeks. Operative mortality was 0.5% during the inpatient stay and 1.0% (95% confidence interval 0.7% to 1.3%) by 30 days.


CONCLUSIONS
Only 20% of symptomatic patients had surgery within the two week target time set by the National Institute for Health and Clinical Excellence (NICE). Although operative mortality rates are comparable with those in other countries, some patients might experience disabling or fatal stroke while waiting for surgery and hence not be included in operative statistics. Major improvements in services are necessary to enable early surgery in appropriate patients in order to prevent strokes.
Halliday
Alison W
AW
St George's, University of London, London SW17 0RE. alisonhalliday@aol.com
Lees
Tim
T
Kamugasha
Dora
D
Grant
Robert
R
Hoffman
Alex
A
Rothwell
Peter M
PM
Potter
John F
JF
Horrocks
Michael
M
Naylor
Ross
R
Rudd
Anthony G
AG
D000368:Aged; D002545:Brain Ischemia / Q000601:surgery; D002340:Carotid Artery Diseases / Q000401:mortality / Q000601:surgery; D016894:Endarterectomy, Carotid / Q000401:mortality / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D020521:Stroke / Q000601:surgery; D006113:United Kingdom; D014850:Waiting Lists