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

J. Mocco, David A. Wilson, Andrew F. Ducruet, Ricardo J Komotar, William J. Mack, Joseph Zurica, Robert R. Sciacca, Eric J. Heyer, E. Sander Connolly

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background and Purpose - Although the incidence of major stroke attributable to carotid endarterectomy (CEA) is low (1% to 2%), ≈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.

Original languageEnglish
Pages (from-to)240-242
Number of pages3
JournalStroke
Volume37
Issue number1
DOIs
StatePublished - Jan 1 2006
Externally publishedYes

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Carotid Endarterectomy
Carotid Stenosis
Monocytes
Multivariate Analysis
Leukocyte Count
Pathologic Constriction
Leukocytes
Logistic Models
Stroke
Incidence

Keywords

  • Carotid endarterectomy
  • Ischemia
  • Neuropsychology

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Neuroscience(all)

Cite this

Elevations in preoperative monocyte count predispose to acute neurocognitive decline after carotid endarterectomy for asymptomatic carotid artery stenosis. / Mocco, J.; Wilson, David A.; Ducruet, Andrew F.; Komotar, Ricardo J; Mack, William J.; Zurica, Joseph; Sciacca, Robert R.; Heyer, Eric J.; Connolly, E. Sander.

In: Stroke, Vol. 37, No. 1, 01.01.2006, p. 240-242.

Research output: Contribution to journalArticle

Mocco, J. ; Wilson, David A. ; Ducruet, Andrew F. ; Komotar, Ricardo J ; Mack, William J. ; Zurica, Joseph ; Sciacca, Robert R. ; Heyer, Eric J. ; Connolly, E. Sander. / Elevations in preoperative monocyte count predispose to acute neurocognitive decline after carotid endarterectomy for asymptomatic carotid artery stenosis. In: Stroke. 2006 ; Vol. 37, No. 1. pp. 240-242.
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AU - Wilson, David A.

AU - Ducruet, Andrew F.

AU - Komotar, Ricardo J

AU - Mack, William J.

AU - Zurica, Joseph

AU - Sciacca, Robert R.

AU - Heyer, Eric J.

AU - Connolly, E. Sander

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N2 - Background and Purpose - Although the incidence of major stroke attributable to carotid endarterectomy (CEA) is low (1% to 2%), ≈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.

AB - Background and Purpose - Although the incidence of major stroke attributable to carotid endarterectomy (CEA) is low (1% to 2%), ≈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.

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