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. 2019 Oct 30;8(21):e013412. doi: 10.1161/JAHA.119.013412

Table 3.

Components of the NSQIP Registry CEA Scale Score

Points Variable Stratification Prevalence, %
Derivation Population (2011–2013) Validation Population (2014–2015)
1 Comorbidity Chronic obstructive pulmonary disease 10.0 10.1
2 Comorbidity Hypertension 85.2 82.0
2 Laboratory value Anemia (hematocrit <36%) 23.0 21.6
3 Patient age >80 y 18.1 16.0
3 Comorbidity Non–insulin‐dependent diabetes mellitus 18.2 19.0
3 Laboratory value Renal insufficiency (GFR <40 mL/min per 1.73 m2) 10.6 9.1
3 Symptomatic Presentation with a transient ischemic attack 15.7 16.4
3 High‐risk features High‐risk anatomical characteristics 11.9 10.8
3 Contralateral carotid artery stenosis High‐grade stenosis (80%–99%), occlusion, or imaging not obtained 22.9 21.3
4 Comorbidity Insulin‐dependent diabetes mellitus 10.8 12.1
4 High‐risk features High‐risk physiological characteristics 4.9 4.7
4 Admission type Hospital transfer, emergency department, or nursing home 6.7 7.2
4 Case urgency Emergent 2.5 2.8
4 ASA classification IV–V 16.5 20.3
5 Symptomatic Presentation with a stroke 18.4 20.0
5 Modified Rankin Scale Score 2–5 7.8 7.6
47 Maximum potential score

High‐risk anatomical characteristics were defined by the NSQIP registry as prior ipsilateral CEA or carotid artery stent placement, prior ipsilateral neck dissection, contralateral carotid artery occlusion, prior radiation to the neck, or contralateral laryngeal nerve injury or palsy. High‐risk physiological characteristics were defined as New York Heart Association class III/IV congestive heart failure, left ventricular ejection fraction <30%, unstable angina, or myocardial infarction within 30 days. ASA physical classification designation IV is a severe systemic disease with constant threat to life and includes, but is not limited to, recent (<3 months) myocardial infarction or cardiac stent placement, severe valve dysfunction, sepsis, and renal dysfunction. ASA class V designation is a moribund patient not expected to survive without the operation. Modified Rankin Scale score of 2 to 5 indicates at least slight disability and is only recorded among patients who presented with a stroke. ASA indicates American Society of Anesthesiologists; CEA, carotid endarterectomy; GFR, glomerular filtration rate; NSQIP, National Surgical Quality Improvement Program.