The Gupta Perioperative Risk for Myocardial Infarct or Cardiac Arrest (MICA) Calculator as an Intraoperative Neurologic Deficit Predictor in Carotid Endarterectomy

• Type: Article in International Scientific Journal
• Date: 2022

Authors

Pereira Macedo, J (Author) Other; Lopes Fernandes, B (Author) Other; Duarte Gamas, L (Author) Other; Pereira Neves, A (Author) Other; J Mourão (Author) FMUP; Khairy, A (Author) Other; Andrade, JP (Author) FMUP; Marreiros, A (Author) Other; Rocha Neves, J (Author) FMUP

Journal

Title: Journal of Clinical Medicine

Vol. 11

Final page: 6367

ISSN: 2077-0383

Publisher: MDPI

Indexing

ISI Web of Knowledge - 1 Citation

Scopus - 2 Citations

Other information

Authenticus ID: P-00X-CN5

DOI: 10.3390/jcm11216367

Abstract (EN): Background: Patients undergoing carotid endarterectomy (CEA) may experiment intraoperative neurologic deficits (IND) during carotid cross-clamping. This work aimed to assess the impact of the Gupta Perioperative Myocardial Infarct or Cardiac Arrest (MICA) risk calculator in the IND. Methods: From January 2012 to April 2021, patients undergoing CEA with regional anaesthesia for carotid stenosis with IND and consecutively control operated patients without IND were selected. A regressive predictive model was created, and a receiver operating characteristic (ROC) curve was applied for comparison. A multivariable dependence analysis was conducted using a classification and regression tree (CRT) algorithm. Results: A total of 97 out of 194 included patients developed IND. Obesity showed aOR = 4.01 (95% CI: 1.66-9.67) and MICA score aOR = 1.21 (1.03-1.43). Higher contralateral stenosis showed aOR = 1.29 (1.08-1.53). The AUROC curve was 0.656. The CRT algorithm differentiated obese patients with a MICA score >= 8. Regarding non-obese patients, the model identified the presence of contralateral stenosis >= 55% with a MICA >= 10. Conclusion: MICA score might play an additional role in stratifying patients for IND in CEA. Obesity was determined as the best discrimination factor, followed by a score >= 8. A higher ipsilateral stenosis degree is suggested to have a part in avoiding procedure-related IND. Larger studies might validate the benefit of MICA score regarding the risk of IND.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 13