Background:Contemporary, nationally representative 30-day readmissions data after carotid artery stenting (CAS) and carotid endarterectomy (CEA) are lacking.Methods:Patients undergoing CAS or CEA were identified from the 2013 to 2014 Nationwide Readmissions Databases. Propensity matching was used to balance baseline clinical characteristics. Thirty-day nonelective readmission rates, length of stay, and causes of readmission were compared.Results:Overall, 85 337 (national estimate of 194 332) patients were identified before propensity score matching, 11 490 (13.4%) of whom underwent CAS and 73 847 (86.6%) of whom underwent CEA. Crude 30-day readmission rates were higher for patients treated with CAS than CEA (8.3% versus 6.8%; P<0.001), but these differences were negated in the propensity-matched cohort (n=22 214; 8.4% versus 7.9%, P=0.20), and readmission length of stay was longer for CEA than CAS (2 versus 1 day, respectively; P=0.002). The most common reasons for readmission were neurological and cardiac events; readmission reasons varied by revascularization modality. Readmission due to a stroke or transient ischemic attack was more common among patients treated with CAS than CEA (1.2% versus 0.9%; P=0.042), while readmission for procedural or medical complications occurred more often following CEA than CAS (1.1% versus 0.5%; P<0.001); readmission rates for cardiac causes were similar between groups.Conclusions:Less than 8% of patients are readmitted within 30 days of a carotid revascularization procedure. After adjusting for baseline differences, readmission rates are similar for CAS and CEA although readmission length of stay is longer after the latter. Readmission for neurological causes was more common following CAS while readmission for procedural or medical complications occurred more often following CEA. Higher annual institutional CEA volumes were associated with lower risk for 30-day readmission; in contrast, institutional CAS volumes were not related to readmission risk. These data provide important insights into the short-term, outcomes of patients following carotid artery revascularization.

中文翻译：

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颈动脉支架置入术与动脉内膜切除术后再入院30天

背景：缺乏在全国范围内具有代表性的颈动脉支架置入术（CAS）和颈动脉内膜切除术（CEA）后的30天再入院数据。方法：从2013年至2014年全国入院数据库中识别接受CAS或CEA的患者。倾向匹配用于平衡基线临床特征。比较了30天非选择性入院率，住院时间和再次入院的原因。结果：总体上，在倾向得分匹配之前确定了85 337名患者（全国估计为194 332名），其中11 490名（13.4％）接受了CAS和73 847（86.6％）人接受了CEA。接受CAS治疗的患者的30天原始入院率高于CEA（8.3％比6.8％；P<0.001），但在倾向匹配的人群中这些差异被否定了（n = 22 214； 8.4％vs 7.9％，P = 0.20），CEA的再入院时间比CAS长（分别为2天和1天）。 ；P＝ 0.002）。再次入院的最常见原因是神经系统疾病和心脏事件。再次入院的原因因血运重建方式而异。中风或短暂性脑缺血发作引起的再入院在接受CAS治疗的患者中比CEA更为常见（1.2％对0.9％；P = 0.042），而因CEA接受手术或医学并发症的再入院率高于CAS（1.1％对0.5） ％; P<0.001）; 两组之间因心脏原因引起的再入院率相似。结论：在颈动脉血运重建手术后30天内，少于8％的患者再次入院。调整基线差异后，CAS和CEA的再入院率相似，尽管后者的再入院时间更长。因CAS引起的神经系统原因再次入院更为常见，而因CEA引起的因程序或医学并发症引起的再次入院更为常见。较高的年度机构CEA量与30天再次入院的风险较低相关；相反，机构CAS数量与再入院风险无关。这些数据为了解颈动脉血运重建术后患者的短期预后提供了重要的见识。