Evidence map›Paper›PMID 26308635›Full record

Observational studyNeurosurgery2015

Impact of Cognitive Dysfunction on Survival in Patients With and Without Statin Use Following Carotid Endarterectomy.

Eric J Heyer, Joanna L Mergeche, Shuang Wang, John G Gaudet, E Sander Connolly

Expression of concernAbstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Neurosurgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It carries an expression of concern. Cited by 11 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 3 pooled it
2.4field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 3 syntheses or guidelines pooled it, 23 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Review
  5. Postoperative cognitive dysfunction: a concept analysis.Aging clinical and experimental research · 2024
    Review
  6. Article
  7. Review
  8. Article
  9. Article
  10. Observational
  11. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Eric J HeyerDepartments of *Anesthesiology and ‡Neurology, Columbia University, New York, New York; §Albert Einstein College of Medicine, Bronx, New York; ‖Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York; ¶Neurological Surgery, Columbia University, New York, New York.
Joanna L Mergeche
Shuang Wang
John G Gaudet
E Sander Connolly
Columbia University · USAlbert Einstein College of Medicine · USColumbia University Irving Medical Center · US

Funding

Neuropsychological Outcome of Carotid EndarterectomyR01AG017604 · NIA · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI HEYER, ERIC JOHN · 2001 to 2012
$3.2M
NIA NIH HHS R01 AG17604
6 · The paper itself

Abstract

backgroundEarly cognitive dysfunction (eCD) is a subtle form of neurological injury observed in ∼25% of carotid endarterectomy (CEA) patients. Statin use is associated with a lower incidence of eCD in asymptomatic patients having CEA.

objectiveTo determine whether eCD status is associated with worse long-term survival in patients taking and not taking statins.

methodsThis is a post hoc analysis of a prospective observational study of 585 CEA patients. Patients were evaluated with a battery of neuropsychometric tests before and after surgery. Survival was compared for patients with and without eCD stratifying by statin use. At enrollment, 366 patients were on statins and 219 were not. Survival was assessed by using Kaplan-Meier methods and multivariable Cox proportional hazards models.

resultsAge ≥75 years (P = .003), diabetes mellitus (P < .001), cardiac disease (P = .02), and statin use (P = .014) are significantly associated with survival univariately (P < .05) by use of the log-rank test. By Cox proportional hazards model, eCD status and survival adjusting for univariate factors within statin and nonstatin use groups suggested a significant effect by association of eCD on survival within patients not taking statin (hazard ratio, 1.61; 95% confidence interval, 1.09-2.40; P = .018), and no significant effect of eCD on survival within patients taking statin (hazard ratio, 0.98; 95% confidence interval, 0.59-1.66; P = .95).

conclusioneCD is associated with shorter survival in patients not taking statins. This finding validates eCD as an important neurological outcome and suggests that eCD is a surrogate measure for overall health, comorbidity, and vulnerability to neurological insult. ABBREVIATIONS: aHR, adjusted hazards ratiosCEA, carotid endarterectomyCI, confidence intervalDM, diabetes mellituseCD, early cognitive dysfunctionNDI, National Death IndexNLR, neutrophil/lymphocyte ratioSD, standard deviationSEM, standard error of the mean.

Indexed as

AgedCarotid StenosisCognition DisordersComorbidityEndarterectomy, CarotidFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsIncidenceMaleMiddle AgedProportional Hazards ModelsProspective StudiesRisk FactorsTreatment OutcomeHydroxymethylglutaryl-CoA Reductase Inhibitors

Identifiers

PMID26308635
OpenAlexW1228546030

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.