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Mental status outcomes following carotid endarterectomy: a six-month analysis
Insights
Carotid endarterectomies did not significantly improve mental status or psychosocial well-being compared to other groups in patients with carotid artery disease. Neuropsychological measures and quality of life showed no significant group interactions over time.
Area of Science:
- Neurology
- Neuropsychology
- Vascular Surgery
Background:
- Symptomatic carotid artery disease poses risks for stroke.
- Carotid endarterectomy is a common surgical intervention.
- The impact of this surgery on cognitive and psychosocial outcomes requires further investigation.
Purpose of the Study:
- To evaluate the effects of carotid endarterectomy on cognitive function and psychosocial well-being.
- To compare outcomes in patients undergoing carotid endarterectomy versus those with untreated disease or unrelated surgery.
- To assess changes in neuropsychological measures and quality of life post-surgery.
Main Methods:
- Three patient groups were established: carotid endarterectomy, non-operative symptomatic disease, and unrelated surgery.
- Participants completed comprehensive neuropsychological assessments (WAIS, Wechsler Memory Scale, Halstead-Reitan) and quality of life measures (Sickness Impact Profile, Profile of Mood States).
- Assessments were performed pre-surgery and at a 6-month follow-up, with data analyzed using two-way analyses of variance.
Main Results:
- A significant effect of time (trials) was observed across most variables, indicating changes over the assessment period.
- No significant group by time interactions were found for neuropsychological measures or quality of life indices.
- Cognitive function (WAIS IQ) and impairment ratings showed changes over time but not differentially between surgical and non-surgical groups.
Conclusions:
- The study did not find evidence that carotid endarterectomy leads to improved mental status.
- Carotid endarterectomy did not demonstrate a significant benefit in enhancing psychosocial well-being compared to control groups.
- Further research may be needed to understand long-term cognitive and quality of life trajectories in patients with carotid artery disease.
Abstract:
Fifty-one male and two female patients were divided into the following three groups: (a) patients with symptomatic carotid artery disease who received carotid endarterectomies, (b) patients with symptomatic carotid artery disease who either declined or were not candidates for carotid endarterectomies, and (c) patients who received a surgical procedure unrelated to cerebral functioning. The three groups were not significantly different in terms of age or educational level. The subjects were examined using the WAIS, Wechsler Memory Scale, Halstead-Reitan Neuropsychological Battery, Sickness Impact Profile, and Profile of Mood States. The assessments were conducted presurgery and repeated at a 6 month follow-up. The results of two-way analyses of variance revealed a significant trials effect for a majority of the variables, including the average impairment rating and the full scale WAIS IQ. However, significant group x trials interactions were not found for either the neuropsychological measures or the quality of life indices. The results did not support the conclusion of improved mental status or increased psychosocial well-being in patients who received carotid endarterectomies.