The impact of advanced age on the results of carotid endarterectomy: an outcome analysis

BACKGROUND: This study examined whether advanced age adversely influences the outcome of carotid endarterectomy. STUDY DESIGN: The records of 173 patients who underwent 187 carotid endarterectomies performed by the author from January 1990 through December 1995 were retrospectively reviewed. Group 1 included 58 patients, ranging in age from 75 to 92 years (mean, 79.4 years), who underwent 63 procedures, and group 2 included 115 patients, ranging in age from 41 to 74 years (mean, 66.3 years), who underwent 124 procedures. The operation was performed for symptomatic disease in 67 percent of the cases in each group. The operated lesion was more than 80 percent stenotic in 85 percent of the group 1 and 79 percent of the group 2 cases. RESULTS: No significant differences were found in the operative mortality (1.6 percent compared with 1.6 percent), incidence of perioperative stroke (4.8 percent compared with 1.6 percent), or rate of major cardiac complications (7.9 percent compared with 7.3 percent) between groups 1 and 2. No significant difference was found in the mean postoperative length of hospital stay between the group 1 and group 2 patients (4.13 +/- 2.58 days compared with 3.68 +/- 1.40 days). However, during the last 2 years of the study, the mean postoperative length of stay among the group 2 patients (3.06 +/- 1.44 days) was significantly shorter than among the group 1 patients (4.15 +/- 1.45 days) (p < .05). CONCLUSIONS: Advanced age does not adversely affect the results of carotid endarterectomy. However, the very elderly may be expected to experience a longer postoperative length of stay because of associated comorbid conditions.