Post‐operative risk factor control following internal carotid artery intervention

Abstract

Patients who undergo carotid surgical interventions remain at significant risk of further vascular events post-operatively. This study evaluates the level of risk factor monitoring and control being achieved post-operatively for patients who undergo carotid surgical interventions within Southern Health and investigates the significance of patient education and patient insight in this context. The study included all patients who underwent successful carotid endarterectomy (CEA) or carotid angioplasty within Southern Health during the 5-year study period. To ascertain the objective risk factor status of participants, the most current reported measurements for the variables of blood pressure, blood lipids and glycosylated hemoglobin were obtained from the participant's usual medical attendants. To ascertain the participant's subjective perceptions of their risk factor status, participants completed a self-administered mail-out questionnaire. A high level of post-operative risk factor monitoring was demonstrated. Post-operative risk factor control was not as commendable. There was a significant discrepancy identified between patient perceptions of current post-operative risk factor status and the objective reality of current post-operative risk factor status. There was a moderate positive linear correlation between level of accurate patient insight into their disease (including their post-operative risk factor control) and the level of postoperative risk factor control being achieved (r = 0.51, P <0.001). Future strategy targeted at achieving optimal post-CEA and carotid angioplasty with adjuvant stenting risk factor control should consider incorporating themes that increase the level of accurate patient insight into their disease (particularly their post-operative risk factor control), for instance, patient education and effective doctor-patient communication.