Risk Prediction Model of Conrad et al for Carotid Endarterectomy in a Patient with Asymptomatic Carotid Artery Stenosis

Description

A patient with asymptomatic carotid artery stenosis has a 2% annual carotid artery related risk of stroke if medically managed. Conrad et al developed a model to determine if a patient with asymptomatic carotid artery stenosis is likely to benefit from carotid endarterectomy (CEA). The authors are from the Massachusetts General Hospital.

Patient selection: asymptomatic carotid artery stenosis (> 70%)

Outcome: 5-year survival

Parameters:

(1) age in years

(2) coronary artery disease (CAD)

(3) statin therapy

(4) diabetes mellitus

(5) history of neck radiation

(6) chronic obstructive pulmonary disease (COPD)

(7) serum creatinine concentration in mg/dL

Parameter	Finding	Points
age in years	< 50 years	0
	50 to 59 years	2
	60 to 69 years	4
	70 to 79 years	6
	80 to 89 years	8
	>= 90 years of age	10
coronary artery disease	no	0
	yes	2
statin therapy	no	2
	yes	0
diabetes	no	0
	yes	2
neck radiation	no	0
	yes	3
COPD	no	0
	yes	3
serum creatinine	<= 1.5 mg/dL	0
	> 1.5 mg/dL	3

total score =

= SUM(points for all 7 parameters)

Interpretation:

• minimum score: 0

• maximum score: 25

• The higher the score the greater the 5-year mortality.

• A patient with a score <= 8 may be an excellent candidate for CEA.

• A patient with a score >= 12 may be better managed medically.

Score	5-Year Mortality
0 to 5	7.5%
6 to 8	16.4%
9 to 11	36.3%
12 to 14	53.5%
15 to 25	66.2%

Performance:

• The area under the ROC curve was 0.74.

To read more or access our algorithms and calculators, please log in or register.

Risk Prediction Model of Conrad et al for Carotid Endarterectomy in a Patient with Asymptomatic Carotid Artery Stenosis

Description

Specialty