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Are Adverse Events after Carotid Endarterectomy Reported

Research Authors
A.G. Taha, P. Vikatmaa, A. Alback, P.S. Aho, M. Railo, and M. Lepantalo
Research Department
Research Journal
European Journal of Vascular and Endovascular Surgery
Research Member
Research Publisher
N/A
Research Rank
0
Research Vol
35
Research Website
N/A
Research Year
2008
Research_Pages
pp. 280-285
Research Abstract

Objectives. To assess the extent of discrepancies between different vascular registries, at various levels of validation, and to
investigate whether such differences might alter the morbidity and mortality rates obtained from the gold standard dataset
for carotid endarterectomy (CEA).
Methods. All CEA operations in Helsinki University Central Hospital from 2000e2005 were retrieved from the local vascular
registry (HUSVASC) and the Hospital Discharge Registry (HILMO). Both registries were validated at different
levels to form the final dataset. Total and indication-specific perioperative morbidity and mortality rates were estimated
from each level of validation and compared with those from the final dataset and with pooled rates from systematic reviews.
Results. Initial search provided 675 and 681 CEAs from HUSVASC and HILMO, respectively, decreasing to 636 (94%)
and 614 (90%) when using the specific operative codes for thrombendarterectomy and patch angioplasty. Manual verification
of initial HUSVASC results proved that 655 (97%) operations were true CEAs. 18 further proven CEAs, registered
only in HILMO, were added to form the final CEA dataset (n ¼ 673). The peri-operative morbidity and combined morbidity
and mortality rates were 2.23% and 2.67%, respectively. Comparable rates were obtained from both registries, irrespective
the level of verification.
Conclusion. Registry data do not appear to be biased by random loss of some operations and thus they are reliable for
decision-making. However, further research is still needed to estimate the permissible volume of omissions in a registry
for the data-base to remain trustworthy.
 2007 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.