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

• Tipo: Artigo em Revista Científica Internacional
• Data: 2022

Autores

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

Revista

Título: Journal of Clinical Medicine

Vol. 11

Página Final: 6367

ISSN: 2077-0383

Editora: MDPI

Indexação

ISI Web of Knowledge - 1 Citação

Scopus - 2 Citações

Outras Informações

ID Authenticus: 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.

Idioma: Inglês

Tipo (Avaliação Docente): Científica

Nº de páginas: 13