Abstract

Abstract Aims Carotid endarterectomy is the gold standard intervention to reduce carotid stenosis induced embolic cerebrovascular events. Current literature lacks long-term large sample analysis for post-carotid surgery mortality risks. The aim of this study was to determine long term all-cause mortality after carotid surgery. Method Single centre 10-year retrospective observational study of CEA mortality evaluating pre, intra and post-operative factors between 2010 and 2020. The data was manually extracted from the hospital’s database. Odds ratios and mortality rates were calculated and adjusted for age by adapting linear regression. Results 970 patients’ data were identified with an average follow up of 6.65 ±3.37 years for an average mortality rate of 31.9%. There was a non-significant (p>0.05) age adjusted odd of survival between gender (aOR 1.81 ±0.298) elective admission (aOR 0.932 ±0.321) and symptomatic patients (aOR 1.274 ±0.47). There was a significantly (p>0.05) decreased chance of survival for current smokers (aOR 0.433 ±0.54) and patients on ACE/ARB (aOR 0.516 ±0.091). On the other hand, single (aOR 2.934 ±0.531) and dual anti-platelet (aOR 4.964 ±0.286) showed a significant (p>0.05) protective effect. The 5-year age-adjusted death rate was elevated for all patients at 1.42. Conclusion The results highlight the smoking cessation, DAPT and appropriate prophylaxis remain important factors in increasing survival odds post carotid surgery. 30% mortality at 5 years is similar to those after Aortic interventions in these arteriopathic patients with extensive co morbidities.

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