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 PS48. Do Women Experience Delays in Carotid Endarterectomy?

SreyRam Kuy, Peter Rossi, Gary Seabrook, Brian Lewis, Anahita Dua, Bhavin Patel, Cheong Lee, Kellie Brown
Division of Vascular Surgery, Medical College of Wisconsin, Milwaukee, WI.

OBJECTIVES: The objectives are to evaluate among hospitalized men and women with carotid disease if women experience a delay in undergoing carotid endarterectomy (CEA) and examine gender based differences in CEA outcomes.
 
METHODS: Cross-sectional study utilizing the Nationwide Inpatient Sample Database, 2000-2009. ICD-9 codes were used to identify patients who underwent CEA. Outcomes measured were time from admission to surgery, mortality, complications, mean length of stay (LOS) and discharge disposition. Bivariate and multivariate regression analysis was performed.

RESULTS: Among 221,291 patients who underwent CEA, on bivariate analysis both symptomatic and asymptomatic women had a longer time from admission to surgery then men (symptomatic 2.8 vs. 2.6 days; asymptomatic 0.53 v. 0.48 days, all p<0.001). However, on multivariable analysis adjusting for other patient and clinical factors, there was no difference between men and women in time from admission to CEA. Asymptomatic women were less likely than men to have a cardiac complication (OR 0.90) or mortality (OR 0.83). Symptomatic women were also less likely than men to have a cardiac complication (OR 0.78). However, women were more likely to be discharged to a facility or requiring home health (symptomatic OR 1.26; asymptomatic OR 1.18).
 
CONCLUSIONS: This is the first national population based study examining whether women experience a longer time from admission to surgery. After adjusting for other patient and clinical factors, gender did not affect timing of surgery. Interestingly, women were less likely than men to have a cardiac complication or die, but more likely to require home health or nursing home care after discharge.
 
AUTHOR DISCLOSURES: K. Brown: Nothing to disclose; A. Dua: Nothing to disclose; S. Kuy: Nothing to disclose; C. Lee: Nothing to disclose; B. Lewis: Nothing to disclose; B. Patel: Nothing to disclose; P. Rossi: Nothing to disclose; G. Seabrook: Nothing to disclose.
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Posted April 2013

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