Key result
Echolucent carotid plaque predicts ~10-fold higher odds of early cognitive dysfunction after carotid endarterectomy.
Why the study?
The frequency and predictors of postoperative cognitive dysfunction after carotid endarterectomy required evaluation.
What are the predictors of early postoperative cognitive dysfunction in patients undergoing carotid endarterectomy?
Observational (n=41)
No
What are the predictors of early postoperative cognitive dysfunction in patients undergoing carotid endarterectomy?
Odds Ratio: 10 (95% CI 1.5–69.3)
p-value: p=0.019
Carotid echolucent plaque, prior cerebral infarction, and lower education level are strong predictors of early postoperative cognitive dysfunction after carotid endarterectomy, suggesting the involvement of microemboli and reduced cerebral reserve.
頸動脈内膜剥離術41例における術後高次脳機能障害（Postoperative cognitive dysfunction：POCD）の頻度と予測因子を検討した．術前に全例でMRIと頸動脈エコーを，25例に脳血流シンチを施行した．POCDは39％に発症し，多変量解析によるPOCDの予測因子は，頸動脈低輝度プラーク（Odds ratio：OR 10.0），陳旧性脳梗塞（OR 4.0）および教育歴≦9年（OR 8.6）であった．さらに，POCD群は脳血流シンチで前・中大脳動脈領域の循環予備能低下が認められた．POCDには微小塞栓と脳予備能低下の関与が示唆された．
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Tashima et al. (2017) conducted an observational in Carotid artery stenosis undergoing carotid endarterectomy (n=41). Echolucent carotid plaque vs. Absence of echolucent carotid plaque was evaluated on Postoperative cognitive dysfunction (POCD) (OR 10.0, 95% CI 1.5-69.3, p=0.019). Echolucent carotid plaque (OR 10.0), preoperative cerebral infarcts (OR 4.0), and education ≤9 years (OR 8.6) were identified as independent predictors of early postoperative cognitive dysfunction after carotid endarterectomy.
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