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在一般容量的社区医院中,接受颈动脉内膜切除术的有症状和无症状患者的长期结果。

Long-term outcomes of symptomatic and asymptomatic patients undergoing carotid endarterectomy in an average-volume community hospital.

机构信息

Department of Surgery, Herzzentrum Deutsches Hospital, Buenos Aires, Argentina.

Neuroscience Department, Deutsches Hospital, Buenos Aires, Argentina.

出版信息

Acta Chir Belg. 2021 Dec;121(6):398-404. doi: 10.1080/00015458.2020.1798112. Epub 2020 Jul 25.

Abstract

BACKGROUND

Long-term benefit of carotid endarectomy has not yet been fully investigated in average volume centers. Thus our purpose is to evaluate long-term results of carotid endarterectomies at a medium-volume hospital.

METHODS

A retrospective analysis of carotid artery stenosis operated between 2008 and 2017 in a community hospital was done. Demographic and postoperative outcomes were evaluated in short and long-term by Kaplan-Meier survival analysis.

RESULTS

167 procedures in 159 patients were included. Average age was 72 years, and 65% were men. Twenty-nine percent of the patients were symptomatic and the rest asymptomatic. Median hospitalization was 3 (IQR 3-4) days and the mean follow-up was 56 months. No hospital mortality was recorded. At 120-month follow-up, freedom of stroke was 97.4%, death 97.3%, restenosis, 98.7% and all combined events 92.9% (log rank  = .042) Combined event-free survival was 84.4% in symptomatic patients, and 96.1% in asymptomatic patients (log rank  = .025).

CONCLUSIONS

In a medium-volume hospital combined event-free survival was 84.4% in symptomatic patients and 96.1% in asymptomatic at a 10-year follow-up.

摘要

背景

颈动脉内膜切除术的长期获益在平均容量中心尚未得到充分研究。因此,我们的目的是评估中等容量医院颈动脉内膜切除术的长期结果。

方法

对 2008 年至 2017 年间在社区医院接受颈动脉狭窄手术的患者进行回顾性分析。通过 Kaplan-Meier 生存分析评估短期和长期的人口统计学和术后结果。

结果

共纳入 159 例患者的 167 例手术。平均年龄为 72 岁,65%为男性。29%的患者有症状,其余为无症状。中位住院时间为 3 天(IQR 3-4),平均随访时间为 56 个月。无院内死亡。120 个月随访时,卒中无复发率为 97.4%,死亡率为 97.3%,再狭窄率为 98.7%,所有复合事件发生率为 92.9%(对数秩检验 = 0.042)。症状性患者的无复合事件生存率为 84.4%,无症状患者为 96.1%(对数秩检验 = 0.025)。

结论

在中等容量医院,10 年随访时,症状性患者的无复合事件生存率为 84.4%,无症状患者为 96.1%。

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