Table 1.

Physiologic and anatomic high-risk variables and how they are defined by the Centers for Medicare and Medicaid Services, administrative data, and the National Surgical Quality Improvement Program Database

CMS Definitions	Administrative Data	NSQIP Definitions
Physiologic High Risk
Age > 80 years	Age > 80 years	Age > 80 years
Recent MI within 30 days	** 412	History of a non-Q wave or a Q wave MI within 6 months of surgery
Unstable angina	** 411.1	Angina within 30 days of surgery
CHF class III or IV	** 428	Newly diagnosed CHF or chronic CHF with new symptoms within 30 days of surgery
LVEF < 30%	Unavailable	Unavailable
Hemodialysis	** 585.3 – 585.9, 586, V42.0, V45.1 – V45.12, V56.0 – V56.32, V56.8	Acute or chronic renal failure requiring peritoneal dialysis, hemodialysis, hemofiltration, hemodiafiltration, or ultrafiltration within 2 weeks of surgery
Severe pulmonary disease *	** 490 – 492.8, 493, 494 – 494.1, 495– 505, 506.4	Severe COPD ***
CABG/valve repair within 30 days	** 36.11 – 36.16, 35	CABG/valve repair performed at the same time as CEA
Anatomic High Risk
Contralateral ICA occlusion	Unavailable	Unavailable
Restenosis after CEA	Unavailable	Unavailable
Prior neck surgery	Unavailable	Unavailable
Contralateral laryngeal nerve palsy	Unavailable	Unavailable
History of neck irradiation	Unavailable	Unavailable
High or Low lesion	Unavailable	Unavailable

CMS, Centers for Medicare and Medicaid Services; MI, myocardial infarction; CHF, congestive heart failure; LVEF, left ventricular ejection fraction; CABG, coronary artery bypass grafting; ICA, internal carotid artery; CEA, carotid endarterectomy; COPD, chronic obstruction pulmonary disease

^*Forced expiratory volume in 1 second (FEV1) < 30% of predicted or home oxygen

^**ICD-9-CM codes

^***Functional disability from COPD, hospitalization for treatment of COPD, chronic bronchodilator therapy, or an FEV1 < 75% of predicted