Evidence map›Paper›PMID 30261391›Full record

Observational studyWorld neurosurgery2019

Easily Screenable Characteristics Associated with Cognitive Improvement and Dysfunction After Carotid Endarterectomy.

Trae R Robison, Eric J Heyer, Shuang Wang, Elise Caccappolo, Joanna L Mergeche, Sohum S Shah, Edward Sander Connolly

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in World neurosurgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Trae R RobisonDepartment of Neurological Surgery, Columbia University College of Physicians and Surgeons, New York, New York, USA. Electronic address: trr2116@cumc.columbia.edu.
Eric J HeyerDepartment of Neurological Surgery, Columbia University College of Physicians and Surgeons, New York, New York, USA; Department of Neurology, Columbia University College of Physicians and Surgeons, New York, New York, USA; Department of Anesthesia, Columbia University College of Physicians and Surgeons, New York, New York, USA.
Shuang WangDepartment of Biostatistics, Columbia University Mailman School of Public Health, New York, New York, USA.
Elise CaccappoloDepartment of Neurology, Columbia University College of Physicians and Surgeons, New York, New York, USA.
Joanna L MergecheDepartment of Anesthesia, Columbia University College of Physicians and Surgeons, New York, New York, USA.
Sohum S ShahDepartment of Neurological Surgery, Columbia University College of Physicians and Surgeons, New York, New York, USA.
Edward Sander ConnollyDepartment of Neurological Surgery, Columbia University College of Physicians and Surgeons, New York, New York, USA; Department of Neurology, Columbia University College of Physicians and Surgeons, New York, New York, USA.

Funding

Neuropsychological Outcome of Carotid EndarterectomyR01AG017604 · NIA · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI HEYER, ERIC JOHN · 2001 to 2012
$3.2M
Statin Neuroprotection & Cognitive Dysfunction after Carotid Endarterectomy: Safety, Feasibility, & Outcomes.R01AG050819 · NIA · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI CONNOLLY, EDWARD SANDER, HEYER, ERIC JOHN · 2016 to 2017
$2.1M
NIA NIH HHS R01 AG017604NIA NIH HHS R01 AG050819
6 · The paper itself

Abstract

backgroundCarotid endarterectomy (CEA) is an effective treatment for the prevention of stroke in patients with carotid artery stenosis. We aimed to clarify the incidence and risk factors for early cognitive dysfunction (eCD) and early cognitive improvement (eCI), defined as change in cognitive performance ≤24 hours after surgery, using a battery of neuropsychometric tests.

methodsIn total, 585 patients undergoing CEA were tested with neuropsychometric tests before and after surgery; 155 patients undergoing "simple" spine surgery were the reference group. Patient performance for each test was evaluated by z scores. Cognitive change was defined as eCD (or eCI) if: 1) patients had a z score ≤-2 (or ≥2) in ≥2 cognitive domains or 2) patients had mean z scores across all domains ≤-1.5 (or ≥1.5). Associations between the categorical cognitive outcomes and variables of interest were modeled using the proportional odds model.

resultsOf the 585 subjects, 24% had eCD, 6% had eCI, and 70% had "no change." Patients who had eCD were more likely to be statin naïve (odds ratio [OR] 1.23 [1.03-1.48], P = 0.02) or women (OR 1.27 [1.06-1.53], P = 0.02). Those with eCI were less likely to have less formal education (OR 0.95 [0.90-1.00], P = 0.04) and less likely to have diabetes mellitus (OR 0.8 [0.65-0.99], P = 0.04).

conclusionsPatients having CEA may develop eCD or eCI postoperatively. Medications likely to be associated with less eCD are statins and aspirin, which correlate most strongly in asymptomatic patients. In addition to confirming previous findings, we found that women were more likely than men to develop eCD. More sex-specific studies and analysis are needed to better explore these findings.

Indexed as

AdultAgedAged, 80 and overCarotid StenosisCognition DisordersEarly DiagnosisEndarterectomy, CarotidFemaleHumansMaleMiddle AgedNeuropsychological TestsPostoperative CareProspective StudiesRetrospective StudiesTreatment OutcomeCarotid endarterectomyCarotid stenosisCognitive impairmentNeuropsychometric assessment

Identifiers

PMID30261391
PMCPMC6298836

What OpenQuestion holds

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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.