Epidemiology of carotid endarterectomy among Medicare beneficiaries - 1985-1996 update
Epidemiology of carotid endarterectomy among Medicare beneficiaries - 1985-1996 update
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DOI：
10.1161/01.str.29.2.346
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发表时间：
1998-02-01
期刊：
影响因子：
8.3
通讯作者：
Krushat, M
中科院分区：
文献类型：
--
作者：
Hsia, DC;Moscoe, LM;Krushat, M
背景和目的-本文描述了医疗保险受益人中颈动脉内膜切除术的比率和结果的变化。方法-我们分析了疾病的介入分类，第9次修订，临床修改（ICD-9-CM）代码，以计算颈动脉内膜切除术的频率，比率，结果：在61273例手术达到最初峰值后，（20.6/10000受益人），1989年医疗保险受益人中颈动脉内膜切除术的频率下降到46571（14.3/10000），然后上升到108275（28.6/10000）。患者主要年龄在65 - 74岁，男性，白色;手术主要发生在大型、城市、非营利性和教学医院。围手术期死亡率从1985年的3.0%下降到1996年的1.6%。结论：颈动脉内膜切除术的频率和比率对临床试验的报道有迅速的反应。围手术期死亡率随着时间的推移有所改善和收敛，但没有达到试验报告的比率。年龄在85岁以上的患者平均围手术期死亡率为2倍。
Background and Purpose-This article describes changes in the rate and outcome of carotid endarterectomies among Medicare beneficiaries.Methods-We analyzed Interventional Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes as shown on Medicare bills to calculate carotid endarterectomy frequency, rate, and perioperative mortality by patient demography and hospital characteristics.Results-After initially peaking at 61273 procedures (20.6 per 10000 beneficiaries) in 1985, the frequency of carotid endarterectomy among Medicare beneficiaries declined to 46571 (14.3 per 10000) in 1989 and then rose to 108275 (28.6 per 10000) in 1996. Patients were predominantly aged 65 to 74 years, male, and white; surgery occurred mainly in large, urban, nonprofit, and teaching hospitals. Perioperative mortality declined from 3.0% in 1985 to 1.6% in 1996.Conclusions-The frequency and rate of carotid endarterectomy showed prompt response to reports from clinical trials. Perioperative mortality both improved and converged over time but did not attain the rates reported by the trials. Patients aged 85+ years suffered twice the average perioperative mortality.