C Peck1, J Peck, A Peck. 1. Foundation for Accountability, Oregon Health Science University, 9155 SW Barnes Rd, Suite 304, Portland, OR 97225, USA.
Abstract
BACKGROUND: Population-based studies have demonstrated better outcomes for carotid endarterectomies at high-volume hospitals. METHODS: This is a 2-year retrospective review of carotid procedures at two low-volume hospitals (n = 156) and one high-volume hospital (n = 404) in the metropolitan area of Portland, Oregon. RESULTS: There were no significant differences in 30-day mortality and stroke rates for carotid endarterectomies when comparing low- and high-volume hospitals (P = 0.59). These were comparable rates despite the fact that the low-volume hospitals had significantly older patients (P <0.001), more smokers (P <0.001), more patients with an indication of a previous nondisabling stroke (P <0.01), and fewer patients who were asymptomatic (P <0.01). CONCLUSION: The regionalization of carotid endarterectomy into high-volume hospitals is not justified by the findings of this study. Carotid endarterectomy performed by well-trained, experienced surgeons in low-volume hospitals is a safe procedure.
BACKGROUND: Population-based studies have demonstrated better outcomes for carotid endarterectomies at high-volume hospitals. METHODS: This is a 2-year retrospective review of carotid procedures at two low-volume hospitals (n = 156) and one high-volume hospital (n = 404) in the metropolitan area of Portland, Oregon. RESULTS: There were no significant differences in 30-day mortality and stroke rates for carotid endarterectomies when comparing low- and high-volume hospitals (P = 0.59). These were comparable rates despite the fact that the low-volume hospitals had significantly older patients (P <0.001), more smokers (P <0.001), more patients with an indication of a previous nondisabling stroke (P <0.01), and fewer patients who were asymptomatic (P <0.01). CONCLUSION: The regionalization of carotid endarterectomy into high-volume hospitals is not justified by the findings of this study. Carotid endarterectomy performed by well-trained, experienced surgeons in low-volume hospitals is a safe procedure.
Authors: Glenn M LaMuraglia; David C Brewster; Ashby C Moncure; David J Dorer; Michael C Stoner; Samir K Trehan; Elizabeth C Drummond; William M Abbott; Richard P Cambria Journal: Ann Surg Date: 2004-09 Impact factor: 12.969
Authors: Michiel H F Poorthuis; Eelco C Brand; Alison Halliday; Richard Bulbulia; Michiel L Bots; Gert J de Borst Journal: Ann Surg Date: 2019-04 Impact factor: 12.969