Halm et al identified risk factors associated with stroke or death in a patient undergoing carotid endarterectomy. This can help identify a patient who may benefit from closer monitoring or alternative therapy. The authors are from Mount Sinai School of Medicine the University of Albany, and New York University.
Parameters:
(1) indication for the carotid endarterectomy
(2) coronary artery disease
(3) stenosis in the contralateral carotid artery
(4) anesthesia for the procedure
(5) type of closure
Parameter
Finding
Points
indication for carotid endartectomy
stroke
1
other
0
coronary artery disease
none
0
inactive
0
active
1
stenosis of the contralateral carotid artery
<= 50%
0
> 50%
1
anesthesia
general
1
local
0
type of closure
patch graft or eversion
0
primary
1
where:
• Active coronary artery consists of either unstable angina or angina with ordinary or minimal activity during the past 12 months.
• The odds ratio for local anesthesia and patch graft closure were 0.30 and 0.43 respectively. Rather than using negative numbers in the score I gave points to the reference method.
total number of risk factors =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
• The higher the score the greater the risk for stroke and/or death.
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