Conrad et al developed a model for predicting long-term survival for an asymptomatic patient undergoing a carotid endarterectomy. This can help to decide if the procedure is appropriate for a patient. The authors are from the Massachusetts General Hospital.
Patient selection: asymptomatic carotid artery disease
Parameters:
(1) age in years
(2) coronary artery disease
(3) statin therapy
(4) diabetes mellitus
(5) history of neck irradiation
(6) COPD
(7) serum creatinine in mg/dL
|
Parameter |
Finding |
Points |
|
age in years |
< 50 years of age |
0 |
|
|
50 to 59 years of age |
2 |
|
|
60 to 69 years of age |
4 |
|
|
70 to 79 years of age |
6 |
|
|
80 to 89 years of age |
8 |
|
|
>= 90 years of age |
10 |
|
coronary artery disease |
no |
0 |
|
|
yes |
2 |
|
statin therapy |
no |
2 |
|
|
yes |
0 |
|
diabetes mellitus |
no |
0 |
|
|
yes |
2 |
|
neck irradiation |
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 worse the long-term survival.
• A patient with good long-term survival is likely to benefit from CEA while a patient with poor long-term survival may benefit from medical management.
|
Total Score |
5-Year Survival |
|
0 to 5 |
93% |
|
6 to 8 |
84% |
|
9 to 11 |
64% |
|
12 to 14 |
47% |
|
15 to 25 |
34% |
Performance:
• The area under the ROC curve was 0.74.
Specialty: Neurology
ICD-10: ,
