Influences of age and gender on operative risks following carotid endarterectomy: A systematic review and meta-analysis

被引:2
|
作者
Nantakool, Sothida [1 ]
Chuatrakoon, Busaba [2 ]
Orrapin, Saritphat [3 ]
Leung, Rachel [4 ]
Howard, Dominic P. J. [4 ]
Rerkasem, Amaraporn [1 ]
Derraik, Jose G. B. [1 ,5 ,6 ,7 ]
Rerkasem, Kittipan [1 ,8 ,9 ]
机构
[1] Chiang Mai Univ, Res Inst Hlth Sci, Environm Occupat Hlth Sci & Non Communicable Dis R, EOHS & NCD Res Grp, Chiang Mai, Thailand
[2] Chiang Mai Univ, Fac Associated Med Sci, Dept Phys Therapy, Chiang Mai, Thailand
[3] Thammasat Univ, Fac Med, Dept Surg, Div Vasc Surg, Rangsit Campus, Pathum Thani, Thailand
[4] Univ Oxford, Ctr Prevent Stroke & Dementia, Nuffield Dept Clin Neurosci, Oxford, England
[5] Univ Auckland, Liggins Inst, Auckland, New Zealand
[6] Uppsala Univ, Dept Womens & Childrens Hlth, Uppsala, Sweden
[7] Univ Auckland, Fac Med & Hlth Sci, Dept Paediat Child & Youth Hlth, Auckland, New Zealand
[8] Chiang Mai Univ, Fac Med, Dept Surg, Chiang Mai, Thailand
[9] Chiang Mai Univ, Fac Med, Clin Surg Res Ctr, Chiang Mai, Thailand
来源
PLOS ONE | 2023年 / 18卷 / 05期
关键词
STROKE PREVENTION; STENOSIS; OCTOGENARIANS; COMPLICATIONS; OUTCOMES;
D O I
10.1371/journal.pone.0285540
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
ObjectivesThis review aims to undertake a comprehensive review of the literature and investigate associations of age and gender on 30 days post carotid endarterectomy (CEA) and up to 5 years post CEA stroke, death, and combined stroke and death. DesignA systematic review and meta-analysis. MethodsThree main electronic databases including the Cochrane Library, MEDLINE, and Embase were searched from their inception to July 2022. Studies examining operative risks (i.e., stroke, death, and combined stroke and death following CEA) linked to age or gender were included. Two independent reviewers were responsible for study selection, quality assessment, and data extraction. Odds ratio (OR) and 95% confidence interval (CI) of all outcomes were calculated. Results44609 studies were retrieved from the search. There were 127 eligible studies (80 studies of age, 72 studies of gender, 25 studies of age and gender) for pooling in the meta-analysis. With regards to stroke and death risks within 30 days post CEA; patients aged & GE;75 had higher death (OR 1.38; 95% CI 1.10-1.75) than patients aged <75. Patients aged & GE;80 had higher stroke risk (OR 1.17; 95% CI 1.07-1.27) and death risk (OR 1.85; 95% CI 1.48-2.30) particular in asymptomatic patients (OR 2.4; 95% CI 1.56-3.81). Pooled effect estimates by gender, at 30 days post CEA, showed that female was associated with increased risk of stroke (OR 1.28; 95% CI 1.16-1.40), with more risk in asymptomatic female patients (OR 1.51; 95% CI 1.14-1.99). ConclusionsThis meta-analysis highlights that older people is associated with increased stroke risk, particularly asymptomatic octogenarians who had higher likelihood of death within 30 days post CEA. In addition, female especially those with asymptomatic carotid stenosis had greater likelihood of stroke within 30 days post CEA surgery.
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页数:13
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