ArticleNeurosurgery2006
Predictors of neurocognitive decline after carotid endarterectomy.
Article in Neurosurgery, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It carries an expression of concern. It is linked to trial NCT02808754 (Remote Ischemic Preconditioning for Carotid Endarterectomy), which is not on this map. Cited by 35 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Remote Ischemic Preconditioning for Carotid Endarterectomy
Who cites it
35 citing papers in PubMed, 3 syntheses or guidelines pooled it, 81 citations in OpenAlex.
- The association between diabetes mellitus and postoperative cognitive dysfunction: a systematic review and meta-analysis.International journal of surgery (London, England) · 2025Pooled it
- The risk factors of postoperative cognitive dysfunction in patients undergoing carotid endarterectomy: an updated meta-analysis.Journal of cardiothoracic surgery · 2023Pooled it
- Cognitive Reserve and the Risk of Postoperative Cognitive Dysfunction.Deutsches Arzteblatt international · 2017Pooled it
- Intraoperative magnesium infusion during carotid endarterectomy: a double-blind placebo-controlled trial.Journal of neurosurgery · 2009Trial
- Is Hemispheric Hypoperfusion a Treatable Cause of Cognitive Impairment?Current cardiology reports · 2019Review
- Does severe contralateral carotid artery stenosis affect the outcomes of carotid endarterectomy?Turk gogus kalp damar cerrahisi dergisi · 2019Article
- Easily Screenable Characteristics Associated with Cognitive Improvement and Dysfunction After Carotid Endarterectomy.World neurosurgery · 2019Observational
- Effective collateral circulation may indicate improved perfusion territory restoration after carotid endarterectomy.European radiology · 2018Article
- Failure to account for practice effects leads to clinical misinterpretation of cognitive outcome following carotid endarterectomy.Physiological reports · 2017Article
- Microembolization is associated with transient cognitive decline in patients undergoing carotid interventions.Journal of vascular surgery · 2016Article
- A Prospective Evaluation of Systemic Biomarkers and Cognitive Function Associated with Carotid Revascularization.Annals of surgery · 2016Article
- Genetic Polymorphisms Influence Cognition in Patients Undergoing Carotid Interventions.The International journal of angiology : official publication of the International College of Angiology, Inc · 2016Article
- The Significance of Cerebral Hemodynamics Imaging in Carotid Endarterectomy: A Brief Review.Neurologia medico-chirurgica · 2015Review
- Neutrophil-lymphocyte ratio as a predictor of cognitive dysfunction in carotid endarterectomy patients.Journal of vascular surgery · 2014 · on this mapObservational
- Arterial blood pressure management during carotid endarterectomy and early cognitive dysfunction.Neurosurgery · 2014Article
- Reduced middle cerebral artery velocity during cross-clamp predicts cognitive dysfunction after carotid endarterectomy.Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2014Observational
- Apolipoprotein E-ε4 polymorphism and cognitive dysfunction after carotid endarterectomy.Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2014Observational
- Middle cerebral artery pulsatility index and cognitive improvement after carotid endarterectomy for symptomatic stenosis.Journal of neurosurgery · 2014Observational
- Clinical Outcome after Intra-Arterial Stroke Therapy in the Very Elderly: Why is it so Heterogeneous?Frontiers in neurology · 2014Review
- Neurocognitive functioning after carotid revascularization: a systematic review.Cerebrovascular diseases extra · 2014Review
Corrections and comments
- Expression of concern
Authors and funding
10 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveAlthough the incidence of stroke after carotid endarterectomy (CEA) is low (1-3%), approximately 25% of patients experience subtle declines in postoperative neuropsychometric function. No studies have investigated the risk factors for this neurocognitive change. We sought to identify predictors of postoperative neurocognitive dysfunction.
methodsWe enrolled 186 CEA patients, with both symptomatic and asymptomatic stenosis, to undergo a battery of neuropsychometric tests preoperatively and on postoperative Days 1 and 30. Neurocognitive dysfunction was defined as a two standard deviation decline in performance compared with a similarly aged control group of lumbar laminectomy patients. Univariate logistic regression was performed for age, sex, obesity, smoking, symptomatology, diabetes mellitus, hypertension, hypercholesterolemia, use of statin medication, previous myocardial infarction, previous CEA, operative side, duration of surgery, duration of carotid cross-clamp, and weight-adjusted doses of midazolam and fentanyl. Variables achieving univariate P < 0.10 were included in a multivariate analysis. Data is presented as (odds ratio, 95% confidence interval, P-value).
resultsEighteen and 9% of CEA patients were injured on postoperative Days 1 and 30, respectively. Advanced age predicted neurocognitive dysfunction on Days 1 and 30 (1.93 per decade, 1.15-3.25, 0.01; and 2.57 per decade, 1.01-6.51, 0.049, respectively). Additionally, diabetes independently predicted injury on Day 30 (4.26, 1.15-15.79, 0.03).
conclusionsAdvanced age and diabetes predispose to neurocognitive dysfunction after CEA. These results are consistent with risk factors for neurocognitive dysfunction after coronary bypass and major stroke after CEA, supporting an underlying ischemic pathophysiology. Further work is necessary to determine the role these neurocognitive deficits may play in appropriately selecting patients for CEA.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.