Universität zu Köln

Luebke, Thomas, Ahmad, Wael and Brunkwall, Jan (2015). Gender-based 30-day and long-term outcomes after carotid endarterectomy. Vasa, 44 (4). S. 289 - 296. BERN 9: VERLAG HANS HUBER HOGREFE AG. ISSN 0301-1526

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Abstract

Background: We analyses the effect of gender on short and long-term morbidity and mortality in carotid endarterectomy (CEA) under loco-regional anesthesia. Patients and methods: Patients who were entered into a prospectively compiled computerized database of unilateral, consecutive CEAs performed at our hospital from January 2000 to December 2010 were analysed. Endpoints were perioperative stroke and death, and overall long-term survival rates. Statistical analysis was used to determine the relationships between gender and outcomes after CEA. A Cox proportional hazard model was applied to determine independent risk factors for long term survival. Results: A total of 1880 CEA procedures were performed in the period between 2000 and 2010. Overall, there were 28 (1.48%) neurological deficits according to the ipsilateral carotid supply territory, including minor and major strokes. 7 occurred in the female group (1.19 %), and 21 in the male group (1.62%) with no significant difference between the genders (p = 0.60). No significant difference emerged between female and male patients when postoperative neurological events according to the ipsilateral carotid supply territory were stratified by linical presentation (asymptomatic ICA stenosis: p = 0.75; symptomatic ICA stenosis: p = 0.66). The late overall mortality rate was 4.1% (n = 78) and 26/78 of these late deaths occurred in the female group (33 %). Log rank analysis of Kaplan Meier curves showed no statistically significant difference in long-term survival between the groups (p = 0.74). The multivariate risk factor analysis with the Cox proportinal hazard model revealed age (p < 0.00), and smoking (p = 0.02) as independent risk factors for decreased long term survival. Conclusions: When considering short and long-term outcomes in patients receiving carotid endarterectomy in local anaesthesia gender should not be regarded as a factor on decision-making for carotid interventions in both symptomatic and asymptomatic patients.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Luebke, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Ahmad, Wael UNSPECIFIED UNSPECIFIED UNSPECIFIED Brunkwall, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-399597
DOI:	10.1024/0301-1526/a000444
Journal or Publication Title:	Vasa
Volume:	44
Number:	4
Page Range:	S. 289 - 296
Date:	2015
Publisher:	VERLAG HANS HUBER HOGREFE AG
Place of Publication:	BERN 9
ISSN:	0301-1526
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language REVASCULARIZATION ENDARTERECTOMY; SEX; POPULATION; STENOSIS; WOMEN; ACAS Multiple languages Peripheral Vascular Disease Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/39959