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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Provincial carotid endarterectomy outcomes.
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Provincial carotid endarterectomy outcomes.

机译：省级颈动脉内膜切除术的结果。

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BACKGROUND: Outcomes must be measured as a first step toward improving performance. We sought to measure the national and provincial outcomes from carotid endarterectomy (CE) and explain provincial differences. METHODS: We analyzed a large Canada-wide administrative hospital discharge database of all patients, except those in Quebec, receiving CE in 1994-1997 and used logistic regression for risk adjustment to measure adverse outcomes nationally and by province. Our main outcome measures were in-hospital stroke and/or death. RESULTS: A total of 14,268 patients underwent CE in the years 1994-1997. The overall death rate was 1.3% and the combined stroke and/or death rate was 4.1%. There was a trend towards improvement over the four years. The provinces of Saskatchewan and Newfoundland had significantly higher adverse event rates for the risk-adjusted combined outcome measure. CONCLUSIONS: The outcome of CE in Canada is good and showed improvement over four years. However, significant differences in provincial outcomes were found. This suggests that regionalization across provincial boundaries may be needed to promote higher surgeon and hospital case volumes and thus improve outcomes.
机译：背景：必须对结果进行衡量，以作为提高性能的第一步。我们试图测量颈动脉内膜切除术（CE）的国家和省级结局，并解释省级差异。方法：我们分析了一个大型的全加拿大行政医院出院数据库，除魁北克以外的所有患者，1994-1997年接受CE，并使用逻辑回归进行风险调整以衡量全国和各省的不良后果。我们的主要结局指标是住院中风和/或死亡。结果：在1994-1997年间，共有14268例患者接受了CE。总死亡率为1.3％，中风和/或合并死亡率为4.1％。在过去的四年中，有改进的趋势。萨斯喀彻温省和纽芬兰省的风险调整后的联合结局指标不良事件发生率明显更高。结论：加拿大的CE效果良好，并在四年内有所改善。但是，发现省级结果存在显着差异。这表明可能需要跨省进行区域化以促进更高的外科医生和医院病例数量，从而改善结果。

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