Impact of risk scoring on decision-making in symptomatic moderate carotid atherosclerosis  

Oleh:

Dharmarajah, B. ; Thapar, A. ; Salem, J. ; Lane, T. R. A. ; Leen, E. L. S. ; Davies, A. H.

Jenis: Article from Article - diterbitkan di jurnal ilmiah internasional
Dalam koleksi: BJS: British Journal of Surgery vol. 101 no. 05 (Apr. 2014), page 475-480.

Ketersediaan

Perpustakaan FK Nomor Panggil: B15.K.2014.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Background Benefit from carotid endarterectomy (CEA) in symptomatic moderate (50–69 per cent) carotid stenosis remains marginal. The Fourth National Clinical Guideline for Stroke recommends use of the risk score from the European Carotid Surgery Trial (ECST) to aid decision-making in symptomatic carotid disease. It is not known whether clinicians are, in fact, influenced by it. Methods Using the ECST risk prediction model, three scenarios of patients with a low (less than 10 per cent), moderate (20–25 per cent) and high (40–45 per cent) 5-year risk of stroke were devised and validated. Invitations to complete an online survey were sent by e-mail to vascular surgeons and stroke physicians, with responses gathered. The questionnaire was then repeated with the addition of the ECST risk score. Results Two hundred and one completed surveys were analysed (21·5 per cent response rate): 107 by stroke physicians and 94 by vascular surgeons. The high-risk scenario after the introduction of the ECST risk score showed an increased use of CEA (66·7 versus 80·1 per cent; P?=?0·009). The low-risk scenario after risk score analysis demonstrated a swing towards best medical therapy (23·4 versus 57·2 per cent; P?

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