Neurologic and Functional Long-term Outcome after Carotid Endarterectomy

• Published in: Journal of stroke and cerebrovascular diseases Vol. 23; no. 4; pp. 686 - 693
• Main Authors: Kaźmierski, Piotr, MD, PhD, Stelągowski, Mirosław, MD, PhD, Kasielska-Trojan, Anna, MD, Bogusiak, Katarzyna, MD, Glabinski, Andrzej, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2014
• Subjects: Aged; Cardiovascular; Carotid Stenosis - complications; Carotid Stenosis - surgery; Consciousness Disorders - epidemiology; Consciousness Disorders - etiology; Endarterectomy; Endarterectomy, Carotid - adverse effects; Female; Follow-Up Studies; Health Status; Humans; Male; Middle Aged; Neurologic Examination; Neurology; NIHSS; Quality of Life; Rankin scale; Risk Factors; stroke; Stroke - epidemiology; Stroke - prevention & control; Treatment Outcome; NIHSS; Rankin scale; Endarterectomy; stroke
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2013.06.014

Background The aim of this research was to assess the neurologic status of patients a year after endarterectomy with the use of National Institutes of Health Stroke Scale (NIHSS) and the degree of disability using the modified Rankin Scale (mRS) and to examine the patients' subjective evaluation of their health. Methods One hundred two patients with symptomatic internal carotid artery stenosis who underwent endarterectomy and attended a 1-year follow-up examination were enrolled in the study. The material comprised 72 (70.6%) men and 30 (29.4%) women. Before the surgery, the patients' neurologic status was assessed according to the NIHSS, and their functional status was rated with the mRS. Additionally, the patients were asked to assess their life quality on a 10-point Likert scale. Results The mean NIHSS score before the operation was 2.76 points (SD 2.47), whereas a year after it was 2.05 points (SD 1.84) ( P < .0001). The NIHSS scores that improved significantly a year after endarterectomy were level of consciousness-questions and commands, motor leg, and sensory ( P < .05). Conclusions The patients' neurologic status assessed with the NIHSS improved significantly 1 year after carotid endarterectomy mostly because of the improvement in their verbal and motor communication ability, physical condition and agility, and reduction in sensory disturbances. The observed changes in the neurologic status were reflected in the functional status and subjective life quality assessment, which appeared to be significantly better a year after the surgical treatment.