Carotid endarterectomy in patients aged 75 and over: early results and late outcome

O. Alozairi, R. K. MacKenzie, R. Morgan, Gisu Cooper, J. Engeset, Julie Brittenden

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background: the mean age of patients in the European Carotid Surgery Trial with greater than 70% stenosis was 62 years. With changing demographics older patients are increasingly being referred for carotid endarterectomy (CEA).

Objectives: to assess the complications and survival (stroke-free and overall) of patients over the age of 75 undergoing CEA.

Methods: analysis of a database, clinical records and cause of death of patients undergoing CEA in a single regional unit over a 7 year period (1/4/1993 until 1/4/2000), with follow-up to April 2002. The rates of further neurological events were obtained from the Scottish Morbidity Record 1 (SMR 1) of hospital discharges. Patients referred from outside the region were excluded. Differences between groups were assessed by the Chi-squared test, with Yates correction and log-rank tests.

Results: of the 235 patients undergoing CEAs, 55 (23%) were 75 years or older. The post-operative neurological complication rate was 1.7% in the under 75's and 5.4% in the older group (p < 0.05). The 30 day mortality was 1.1 % (two patients) and 1.8% (one patient) respectively. The Kaplan-Meier estimated survival for the under 75's and older were 93 and 75% at 3 years and 80 and 59% at 5 years respectively (p < 0.001). The Kaplan-Meier estimated neurological event-free 5 year survival for the under 75's and older patients were 96 and 82% respectively (p < 0.001).

Conclusion: CEA in patients aged 75 years and over is associated with a significantly increased risk of stroke and death. CEA may not benefit elderly patients with a reduced life expectancy.

Original languageEnglish
Pages (from-to)245-249
Number of pages4
JournalEuropean Journal of Vascular and Endovascular Surgery
Volume26
Issue number3
DOIs
Publication statusPublished - 2003

Keywords

  • carotid disease
  • age
  • post-operative outcome
  • survival
  • SYMPTOMATIC PATIENTS
  • ELDERLY PATIENTS
  • SURGERY-TRIAL
  • STENOSIS
  • STROKE
  • OCTOGENARIANS
  • DISEASE

Cite this

Carotid endarterectomy in patients aged 75 and over: early results and late outcome. / Alozairi, O.; MacKenzie, R. K.; Morgan, R.; Cooper, Gisu; Engeset, J.; Brittenden, Julie.

In: European Journal of Vascular and Endovascular Surgery, Vol. 26, No. 3, 2003, p. 245-249.

Research output: Contribution to journalArticle

Alozairi, O. ; MacKenzie, R. K. ; Morgan, R. ; Cooper, Gisu ; Engeset, J. ; Brittenden, Julie. / Carotid endarterectomy in patients aged 75 and over: early results and late outcome. In: European Journal of Vascular and Endovascular Surgery. 2003 ; Vol. 26, No. 3. pp. 245-249.
@article{05a67def58c24b1daa018d8dbcab44c2,
title = "Carotid endarterectomy in patients aged 75 and over: early results and late outcome",
abstract = "Background: the mean age of patients in the European Carotid Surgery Trial with greater than 70{\%} stenosis was 62 years. With changing demographics older patients are increasingly being referred for carotid endarterectomy (CEA).Objectives: to assess the complications and survival (stroke-free and overall) of patients over the age of 75 undergoing CEA.Methods: analysis of a database, clinical records and cause of death of patients undergoing CEA in a single regional unit over a 7 year period (1/4/1993 until 1/4/2000), with follow-up to April 2002. The rates of further neurological events were obtained from the Scottish Morbidity Record 1 (SMR 1) of hospital discharges. Patients referred from outside the region were excluded. Differences between groups were assessed by the Chi-squared test, with Yates correction and log-rank tests.Results: of the 235 patients undergoing CEAs, 55 (23{\%}) were 75 years or older. The post-operative neurological complication rate was 1.7{\%} in the under 75's and 5.4{\%} in the older group (p < 0.05). The 30 day mortality was 1.1 {\%} (two patients) and 1.8{\%} (one patient) respectively. The Kaplan-Meier estimated survival for the under 75's and older were 93 and 75{\%} at 3 years and 80 and 59{\%} at 5 years respectively (p < 0.001). The Kaplan-Meier estimated neurological event-free 5 year survival for the under 75's and older patients were 96 and 82{\%} respectively (p < 0.001).Conclusion: CEA in patients aged 75 years and over is associated with a significantly increased risk of stroke and death. CEA may not benefit elderly patients with a reduced life expectancy.",
keywords = "carotid disease, age, post-operative outcome, survival, SYMPTOMATIC PATIENTS, ELDERLY PATIENTS, SURGERY-TRIAL, STENOSIS, STROKE, OCTOGENARIANS, DISEASE",
author = "O. Alozairi and MacKenzie, {R. K.} and R. Morgan and Gisu Cooper and J. Engeset and Julie Brittenden",
year = "2003",
doi = "10.1053/ejvs.2002.1939",
language = "English",
volume = "26",
pages = "245--249",
journal = "European Journal of Vascular and Endovascular Surgery",
issn = "1078-5884",
publisher = "W.B. Saunders Ltd",
number = "3",

}

TY - JOUR

T1 - Carotid endarterectomy in patients aged 75 and over: early results and late outcome

AU - Alozairi, O.

AU - MacKenzie, R. K.

AU - Morgan, R.

AU - Cooper, Gisu

AU - Engeset, J.

AU - Brittenden, Julie

PY - 2003

Y1 - 2003

N2 - Background: the mean age of patients in the European Carotid Surgery Trial with greater than 70% stenosis was 62 years. With changing demographics older patients are increasingly being referred for carotid endarterectomy (CEA).Objectives: to assess the complications and survival (stroke-free and overall) of patients over the age of 75 undergoing CEA.Methods: analysis of a database, clinical records and cause of death of patients undergoing CEA in a single regional unit over a 7 year period (1/4/1993 until 1/4/2000), with follow-up to April 2002. The rates of further neurological events were obtained from the Scottish Morbidity Record 1 (SMR 1) of hospital discharges. Patients referred from outside the region were excluded. Differences between groups were assessed by the Chi-squared test, with Yates correction and log-rank tests.Results: of the 235 patients undergoing CEAs, 55 (23%) were 75 years or older. The post-operative neurological complication rate was 1.7% in the under 75's and 5.4% in the older group (p < 0.05). The 30 day mortality was 1.1 % (two patients) and 1.8% (one patient) respectively. The Kaplan-Meier estimated survival for the under 75's and older were 93 and 75% at 3 years and 80 and 59% at 5 years respectively (p < 0.001). The Kaplan-Meier estimated neurological event-free 5 year survival for the under 75's and older patients were 96 and 82% respectively (p < 0.001).Conclusion: CEA in patients aged 75 years and over is associated with a significantly increased risk of stroke and death. CEA may not benefit elderly patients with a reduced life expectancy.

AB - Background: the mean age of patients in the European Carotid Surgery Trial with greater than 70% stenosis was 62 years. With changing demographics older patients are increasingly being referred for carotid endarterectomy (CEA).Objectives: to assess the complications and survival (stroke-free and overall) of patients over the age of 75 undergoing CEA.Methods: analysis of a database, clinical records and cause of death of patients undergoing CEA in a single regional unit over a 7 year period (1/4/1993 until 1/4/2000), with follow-up to April 2002. The rates of further neurological events were obtained from the Scottish Morbidity Record 1 (SMR 1) of hospital discharges. Patients referred from outside the region were excluded. Differences between groups were assessed by the Chi-squared test, with Yates correction and log-rank tests.Results: of the 235 patients undergoing CEAs, 55 (23%) were 75 years or older. The post-operative neurological complication rate was 1.7% in the under 75's and 5.4% in the older group (p < 0.05). The 30 day mortality was 1.1 % (two patients) and 1.8% (one patient) respectively. The Kaplan-Meier estimated survival for the under 75's and older were 93 and 75% at 3 years and 80 and 59% at 5 years respectively (p < 0.001). The Kaplan-Meier estimated neurological event-free 5 year survival for the under 75's and older patients were 96 and 82% respectively (p < 0.001).Conclusion: CEA in patients aged 75 years and over is associated with a significantly increased risk of stroke and death. CEA may not benefit elderly patients with a reduced life expectancy.

KW - carotid disease

KW - age

KW - post-operative outcome

KW - survival

KW - SYMPTOMATIC PATIENTS

KW - ELDERLY PATIENTS

KW - SURGERY-TRIAL

KW - STENOSIS

KW - STROKE

KW - OCTOGENARIANS

KW - DISEASE

U2 - 10.1053/ejvs.2002.1939

DO - 10.1053/ejvs.2002.1939

M3 - Article

VL - 26

SP - 245

EP - 249

JO - European Journal of Vascular and Endovascular Surgery

JF - European Journal of Vascular and Endovascular Surgery

SN - 1078-5884

IS - 3

ER -