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Invited Critique
June 2013

Risk Adjustment for Outcomes After Carotid Endarterectomy: Comment on “Risk Adjustment for Case Mix and the Effect of Surgeon Volume on Morbidity”

Author Affiliations

Author Affiliation: Division of Vascular Surgery and Endovascular Therapy, Johns Hopkins Hospital, Baltimore, Maryland.

JAMA Surg. 2013;148(6):537. doi:10.1001/jamasurg.2013.1512

The impact of operative volume on surgical outcomes after carotid endarterectomy (CEA) is an area of much debate. Studies based on administrative databases have found that the rates of adverse outcomes are increased in CEA performed by low-volume surgeons.1,2 This has led some to argue for selective referral to high-volume surgeons.