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Risk Models Predict Carotid Endarterectomy Complications

All models are only moderately successful, suggesting further research is required

MONDAY, April 24 (HealthDay News) -- Researchers have identified two risk models that are best at predicting the broad range of complications that can occur following carotid endartarectomy, according to a report in the April 24 issue of the Archives of Internal Medicine.

Ethan A. Halm, M.D., M.P.H., from Mount Sinai School of Medicine in New York City, and colleagues conducted a multi-center observational cohort study of complications occurring within 30 days of carotid endartarectomy (CEA) as recorded in patient medical records from 1998. Regression analysis was used to determine the predictive value of multiple risk models including the Revised Cardiac Risk (RCR) Index and the CEA-specific Halm score.

Overall, 3.2 percent of patients died or had a stroke, 4 percent had cardiac complications, 3.2 percent had noncardiac complications, about 7 percent had minor neurologic complications and 6 percent had wound complications, the investigators found. While all standard cardiac risk models predicted cardiac complications equally well, the RCR was better at predicting a broad range of medical and surgical complications and the Halm score was best at predicting all around performance.

"The modest performance of all the risk models indicates that further research is needed to develop more accurate tools to assess operative risk," the authors conclude.

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