Preoperative Systemic Coagulation Inflammation Index may be a Predictor of Worse Outcomes After Carotid Endarterectomy

Objectives: Stroke is a significant disease associated with high mortality and morbidity rates, and carotid artery stenosis (CAS) is one of its most important causes. Although endovascular applications have increased in the treatment of CAS, carotid endarterectomy (CEA) surgery remains prominent. The systemic coagulation inflammation index (SCII) has emerged as an important marker indicating coagulation and inflammatory status. In this study, we aimed to investigate the effect of SCII values on worse outcomes during 30-day follow-up in patients who underwent CEA.
Methods: This retrospective study consecutively included patients who underwent carotid endarterectomy at our clinic between January 1, 2020, and June 1, 2025. Patients who did not develop worse outcomes within the first 30 days after surgery were assigned to Group 1, and those who did were assigned to Group 2. Worse outcomes in the study were defined as stroke, myocardial infarction, and death.
Results: A total of 594 patients underwent elective CEA surgery. The 546 patients in Group 1 and the 48 patients in Group 2 had median ages of 71 (44–88) and 69 (41–91) years, respectively (p=0.185). As a result of the multivariate analysis, the presence of coronary artery disease (OR: 1.690, 95% CI: 1.210–1.984, p=0.032) and high SCII values (OR: 1.780, 95% CI: 1.270–2.894, p<0.001) were determined as independent predictors of worse outcomes after CEA surgery.
Conclusion: Our results indicated that high SCII values were associated with worse outcomes within 30 days after CEA. In patients undergoing CEA, SCII values can be calculated preoperatively to identify at-risk patient groups; therefore, measures can be taken for patient management and follow-up in the postoperative period.

Keywords: Carotid artery, coagulation, inflammation, morbidity, surgery