title: Waiting times for carotid endarterectomy in UK: observational study.
abstract: 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.
authors.affiliation: St George's, University of London, London SW17 0RE. alisonhalliday@aol.com
authors.forename: Alison W
authors.initials: AW
authors.lastname: Halliday
authors.forename: Tim
authors.initials: T
authors.lastname: Lees
authors.forename: Dora
authors.initials: D
authors.lastname: Kamugasha
authors.forename: Robert
authors.initials: R
authors.lastname: Grant
authors.forename: Alex
authors.initials: A
authors.lastname: Hoffman
authors.forename: Peter M
authors.initials: PM
authors.lastname: Rothwell
authors.forename: John F
authors.initials: JF
authors.lastname: Potter
authors.forename: Michael
authors.initials: M
authors.lastname: Horrocks
authors.forename: Ross
authors.initials: R
authors.lastname: Naylor
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Rudd
mesh_terms: 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