1 / 10

Hospital mortality rate on average is 20% higher in non-trial hospitals.

Hospital mortality rate on average is 20% higher in non-trial hospitals. 60% of hospitals perform fewer than 17 CEA per year. 88% of surgeons perform at or below median value of 21 CEA per year.

onawa
Download Presentation

Hospital mortality rate on average is 20% higher in non-trial hospitals.

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Hospital mortality rate on average is 20% higher in non-trial hospitals. • 60% of hospitals perform fewer than 17 CEA per year. • 88% of surgeons perform at or below median value of 21 CEA per year. • Stroke morbidity is 7.7% in hospitals performing CEA at numbers in the lowest quartile vs 2.5% for the highest quartile (p< 0.03). • CEA results are clearly better in high volume institutions / surgeons.

  2. Carotid Endarterectomy 1971 to 1999 (Rates per Thousand) 1971-- 15,000 CEA performed in U.S. 1974-1985 - CEA most common vascular operation > 1 million worldwide. 1986 and 1988 -Rand data - “substantially overused” 1988-present- complex, randomized, multi-center controlled clinical efficacy trials

  3. 1954-- First carotid reconstruction for stroke prevention 1955 -- First CEA using techniques similar to 1999. 1971 -- 15,000 CEA performed in U.S. 1974-1985 - CEA became firmly established as the most common peripheral vascular operation with over 1 million performed worldwide. 1986 and 1988- Rand Corp data - CEA “substantially overused”

  4. Carotid Endarterectomy 1971 to 1998 (Rates per Thousand) Year

  5. CEA Cases/Quarter/100,000State of Florida 1992-1996 ACAS Advisory

  6. Florida CEA Procedures as Percent of 1992-Q1 Adjusted for Age

  7. 1988-present -- an unprecedented series of complex, randomized, multi-center controlled clinical efficacy trials have been initiated and completed. • NASCET (1991, 1998) • ECST (1991, 1996) • VA Cooperative Studies Program (1991) • CASANOVA (1991) • VA Cooperative Study Group (1993) • ACAS (1995) • ACST (ongoing)

  8. Trials for symptomatic and asymptomatic stenosis %

More Related