Audit of longterm mortality and morbidity outcomes for carotid endarterectomy

Abstract

There have been no Australian studies of longterm mortality status and cause of death after carotid endarterectomy (CEA) or, for survivors, quality-of-life. We first determined rate and cause of death for a cohort of patients four years after CEA. Surviving patients were surveyed to ascertain health status, using MOS SF-36. Of 238 patients who underwent CEA in our health service in 1995, 44 (18.5%) had died within four years. The majority of deaths (61.4%) were attributable to vascular causes. Of the surviving 162 patients (survey response fraction 90%), 10 (6.2%) subsequently had suffered a non-fatal stroke in the four years following their CEA. With respect to health status, Physical Functioning scores differed significantly by age (t=2.65, df=149, P=0.01) as did Role Physical scores (t=2.10, df=142, P=0.04). We conclude that patients undergoing CEA are at high risk of dying from vascular causes, inviting concerted efforts in discharge planning to co-ordinate optimal vascular risk factor management.