An externally validated robust risk predictive model of adverse outcomes after carotid endarterectomy Mohammad H. Eslami, MD, Denis Rybin, MS, Gheorghe.

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An externally validated robust risk predictive model of adverse outcomes after carotid endarterectomy Mohammad H. Eslami, MD, Denis Rybin, MS, Gheorghe Doros, PhD, Alik Farber, MD Journal of Vascular Surgery Volume 63, Issue 2, Pages 345-354 (February 2016) DOI: 10.1016/j.jvs.2015.09.003 Copyright © 2016 Society for Vascular Surgery Terms and Conditions

Fig 1 Vascular Study Group of New England (VSGNE) parsimonious model of predicting adverse outcomes after carotid endarterectomy (CEA). Odds ratios (ORs) and confidence intervals (CIs) as well as β-estimates (Beta) are depicted here. The squares indicate the mean difference and are proportional to the weights used. The vertical line indicates no effect. The horizontal lines represent 95% CI. CHF, Congestive heart disease; PVD, peripheral vascular disease; ICA, internal carotid artery. Journal of Vascular Surgery 2016 63, 345-354DOI: (10.1016/j.jvs.2015.09.003) Copyright © 2016 Society for Vascular Surgery Terms and Conditions

Fig 2 Receiver operating characteristics (ROC) curves of the Vascular Surgery Study Group of New England (VSGNE) predictive model of adverse outcomes after carotid endarterectomy (CEA) applied to the VSGNE CEA cohort and then to the Vascular Quality Initiative (VQI) CEA cohort after removing the VSGNE cases (VQI). AUC, Area under the curve. Journal of Vascular Surgery 2016 63, 345-354DOI: (10.1016/j.jvs.2015.09.003) Copyright © 2016 Society for Vascular Surgery Terms and Conditions

Fig 3 Equations to calculate the odds ratio (OR) and probability of adverse outcomes using the β-estimates for each of the variables included in the model. OR of adverse outcomes is calculated by summation of the β-estimates multiplied by 1 (for presence) or 0 (for absence) of variables in the model that are binomial variables as shown in the example. Probability then can be calculated using the equation shown (e ≈ 2.78). Σ, Sum; CEA, carotid endarterectomy; CHF, congestive heart failure, ICA, internal carotid artery, ICS, internal carotid stenosis, PVD, peripheral vascular disease. Journal of Vascular Surgery 2016 63, 345-354DOI: (10.1016/j.jvs.2015.09.003) Copyright © 2016 Society for Vascular Surgery Terms and Conditions

Fig 4 Crude comparison of adverse outcomes between the Vascular Study Group of New England (VSGNE) carotid endarterectomy (CEA) cohort and the Vascular Quality Initiative (VQI) CEA cohort after removing the VSGNE cases. MI, Postoperative myocardial infarction. ∗P < .05. Journal of Vascular Surgery 2016 63, 345-354DOI: (10.1016/j.jvs.2015.09.003) Copyright © 2016 Society for Vascular Surgery Terms and Conditions

Fig 5 Point distribution of the Vascular Study Group of New England (VSGNE) carotid endarterectomy (CEA) cohort using the devised point scoring system (red) against a hypothetical “normal” distribution curve (blue). The VSGNE cohort was skewed to the right with a mean point score of 3.14. Journal of Vascular Surgery 2016 63, 345-354DOI: (10.1016/j.jvs.2015.09.003) Copyright © 2016 Society for Vascular Surgery Terms and Conditions