title: Outcomes of carotid endarterectomy in the elderly: report from the National Cardiovascular Data Registry.
abstract: OBJECTIVE
  Benchmark trials of carotid endarterectomy often did not include elderly patients, and the results may not be easily extrapolated to the general population. Using the Carotid Artery Revascularization and Endarterectomy registry, we sought to determine real-world outcomes of carotid endarterectomy in the elderly.
  
  
  METHODS
  This was a retrospective cohort study of patients aged >70 years. We compared outcomes stratified by age among symptomatic and asymptomatic patients.
  
  
  RESULTS
  There were 4149 patients who underwent carotid endarterectomy; 1376 (33.1%) were symptomatic. Overall mortality rate was 0.5%. The primary outcome of in-hospital death, stroke, and myocardial infarction showed a significant trend and was highest in the age >85 years group (5.6%). Among symptomatic patients, mortality and the primary outcome were not statistically different between those aged >75 years and those aged 70 to 74 years. Among asymptomatic elderly patients, mortality rate was significantly higher in age group >75 years compared with <75 years (0.7% vs 0.0%); however, the combined outcome of stroke, death, and myocardial infarction was not statistically different.
  
  
  CONCLUSIONS
  Elderly patients >85 years of age were at increased risk for death or perioperative complications of stroke, death, and myocardial infarction compared with those who were relatively younger. More elderly patients underwent carotid endarterectomy for asymptomatic carotid stenosis and had higher mortality than the younger counterparts, underlining need for caution in subjecting them to the procedure.
authors: Wayne State University School of Medicine, Detroit, MI 48201, USA. krajaman@med.wayne.edu
authors: Kumar
authors: K
authors: Rajamani
authors: Kevin F
authors: KF
authors: Kennedy
authors: Nicholas J
authors: NJ
authors: Ruggiero
authors: Kenneth
authors: K
authors: Rosenfield
authors: John
authors: J
authors: Spertus
authors: Seemant
authors: S
authors: Chaturvedi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000401:mortality; D016893:Carotid Stenosis / Q000401:mortality / Q000473:pathology; D015331:Cohort Studies; D016894:Endarterectomy, Carotid / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000473:pathology; D017063:Outcome Assessment, Health Care; D012042:Registries; D012189:Retrospective Studies; D012306:Risk; D020521:Stroke / Q000401:mortality / Q000628:therapy; D016896:Treatment Outcome; D014481:United States