Elevations in preoperative monocyte count predispose to acute neurocognitive decline after carotid endarterectomy for asymptomatic carotid artery stenosis

Document Type

Article

Abstract

BACKGROUND AND PURPOSE: Although the incidence of major stroke attributable to carotid endarterectomy (CEA) is low (1% to 2%), approximately 25% of patients experience subtle postoperative neurocognitive dysfunction. This study examines whether preoperative leukocyte profiles predict cognitive outcome in asymptomatic CEA patients. METHODS: Sixty-nine asymptomatic CEA patients underwent neuropsychometric testing preoperatively and on postoperative day 1 (POD1). Preoperative white blood cell counts and differentials were obtained. Logistic regression was performed for risk factors for neurocognitive decline. Variables achieving univariate P<0.10 were included in multivariate analysis. RESULTS: Eighteen (26%) patients experienced neurocognitive decline on POD1; multivariate analysis demonstrated that preoperative monocyte count (P=0.011) and age (P=0.02) independently predicted outcome. CONCLUSIONS: Preoperative monocyte count and age are independently associated with acute neurocognitive decline after CEA for asymptomatic stenosis.

Medical Subject Headings

Age Factors; Aged; Carotid Artery, Internal (pathology); Carotid Stenosis (complications, surgery); Cerebrovascular Disorders (pathology); Cognition; Cohort Studies; Endarterectomy, Carotid (adverse effects); Female; Humans; Ischemia (pathology); Leukocytes (cytology); Male; Middle Aged; Monocytes (cytology); Multivariate Analysis; Neurodegenerative Diseases (pathology); Regression Analysis; Risk Factors

Publication Date

1-1-2006

Publication Title

Stroke

E-ISSN

1524-4628

Volume

37

Issue

1

First Page

240

Last Page

2

PubMed ID

16322501

Digital Object Identifier (DOI)

10.1161/01.STR.0000195183.04978.4f

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