Association of Centre Quality Certification with Characteristics of Patients, Management, and Outcomes Following Carotid Endarterectomy or Carotid Artery Stenting.

Saicic, Stefan; Knappich, Christoph; Kallmayer, Michael; Kirchhoff, Felix; Bohmann, Bianca; Lohe, Vanessa; Naher, Shamsun; Böhm, Julian; Lückerath, Sofie; Eckstein, Hans-Henning; Kuehnl, Andreas

doi:10.3390/jcm13154407

journal article

Titel:: Association of Centre Quality Certification with Characteristics of Patients, Management, and Outcomes Following Carotid Endarterectomy or Carotid Artery Stenting.
Dokumenttyp:: Journal Article
Autor(en):: Saicic, Stefan; Knappich, Christoph; Kallmayer, Michael; Kirchhoff, Felix; Bohmann, Bianca; Lohe, Vanessa; Naher, Shamsun; Böhm, Julian; Lückerath, Sofie; Eckstein, Hans-Henning; Kuehnl, Andreas
Abstract:: Background: The aim of this study was to analyze the association between center quality certifications and patients' characteristics, clinical management, and outcomes after carotid revascularization. Methods: This study is a pre-planned sub-study of the ISAR-IQ project, which analyzes data from the Bavarian subset of the nationwide German statutory quality assurance carotid database. Hospitals were classified as to whether a certified vascular center (cVC) or a certified stroke unit (cSU) was present on-site or not. The primary outcome event was any stroke or death until discharge from the hospital. Results: In total, 31,793 cases were included between 2012 and 2018. The primary outcome rate in asymptomatic patients treated by CEA ranged from 0.7% to 1.5%, with the highest rate in hospitals with cVC but without cSU. The multivariable regression analysis revealed a significantly lower primary outcome rate in centers with cSU in asymptomatic patients (aOR 0.69; 95% CI 0.56-0.86; p < 0.001). In symptomatic patients needing emergency treatment, the on-site availability of a cSU was associated with a significantly lower primary outcome rate (aOR 0.56; 95% CI 0.40-0.80; p < 0.001), whereas the presence of a cVC was associated with higher risk (aOR 3.07; 95% CI 1.65-5.72). Conclusions: This study provides evidence of statistically significant better results in some sub-cohorts in certified centers. In centers with cSU, the risk of any stroke or death was significantly lower in asymptomatic patients receiving CEA or symptomatic patients treated by emergency CEA.
Zeitschriftentitel:: J Clin Med
Jahr:: 2024
Band / Volume:: 13
Heft / Issue:: 15
Volltext / DOI:: doi:10.3390/jcm13154407
PubMed:: http://view.ncbi.nlm.nih.gov/pubmed/39124674
TUM Einrichtung:: Klinik und Poliklinik für Vaskuläre und Endovaskuläre Chirurgie (Prof. Eckstein)
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Vaskuläre und Endovaskuläre Chirurgie (Prof. Eckstein)2024