Reasons for readmission after carotid endarterectomy

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Updated: May 8, 2026

A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis
09:36

A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis

Published on: August 12, 2025

Aksharananda Rambachan1, Timothy R Smith2, Sujata Saha1

  • 1Department of Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.

World Neurosurgery
|August 27, 2013
PubMed

Insights

Carotid endarterectomy (CEA) readmissions are high. Preoperative factors like bleeding disorders, diabetes, stroke history, and age, along with postoperative complications such as infections and myocardial infarction, predict readmission risk.

Area of Science:

  • Vascular Surgery
  • Health Services Research

Background:

  • The Patient Protection and Affordable Care Act mandates reduced postoperative outcomes, including readmissions, to avoid financial penalties.
  • Carotid endarterectomy (CEA) is a common procedure, and understanding readmission drivers is crucial for quality improvement.

Purpose of the Study:

  • To conduct a multi-institutional, multivariate analysis of pre- and postoperative patient factors associated with 30-day unplanned readmission after CEA.
  • Identify key predictors to guide interventions aimed at reducing costly readmissions.

Main Methods:

  • Utilized data from the National Surgical Quality Improvement Program (NSQIP) for 8456 patients undergoing CEA in 2011.
  • Employed multiple logistic regression, controlling for preoperative demographics, comorbidities, clinical characteristics, and postoperative complications to identify readmission predictors.

Main Results:

  • The overall 30-day unplanned readmission rate after CEA was 6.0%.
  • Significant preoperative predictors included bleeding disorders (OR 1.62), diabetes (OR 1.46), prior cerebrovascular accident/stroke (OR 1.46), and increasing age (OR 1.01).
  • Major postoperative complications associated with readmission were surgical-site infection (OR 21.90), myocardial infarction (OR 10.35), sepsis/septic shock (OR 7.79), cerebrovascular accident/stroke (OR 6.58), pneumonia (OR 4.37), and urinary tract infection (OR 3.21).

Conclusions:

  • Readmission rates following CEA are substantial.
  • Preoperative conditions (bleeding disorders, diabetes, stroke history, age) and postoperative complications (surgical-site infection, myocardial infarction, sepsis, stroke, pneumonia, UTI) are significantly associated with readmission.
  • These findings can inform surgical management strategies to prevent avoidable readmissions.
Abstract

Keywords:
Carotid endarterectomyHealth policyHospital readmissionsNeurosurgeryVascular surgery

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