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The Gupta perioperative risk for myocardial infarct or cardiac arrest (MICA) calculator as an intraoperative neurologic deficit predictor in carotid endarterectomy

2022-10-28Journal article Open Access
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dc.contributor.authorPereira-Macedo, Juliana
dc.contributor.authorFernandes, Beatriz
dc.contributor.authorDuarte-Gamas, Luís
dc.contributor.authorPereira-Neves, António
dc.contributor.authorMourão, Joana
dc.contributor.authorKhairy, Ahmed
dc.contributor.authorAndrade, José Paulo
dc.contributor.authorMarreiros, Ana
dc.contributor.authorRocha-Neves, João
dc.date.accessioned2022-11-11T11:47:10Z
dc.date.available2022-11-11T11:47:10Z
dc.date.issued2022-10-28
dc.date.updated2022-11-10T14:27:50Z
dc.description.abstractBackground: 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.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJournal of Clinical Medicine 11 (21): 6367 (2022)pt_PT
dc.identifier.doi10.3390/jcm11216367pt_PT
dc.identifier.eissn2077-0383
dc.identifier.urihttp://hdl.handle.net/10400.1/18493
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherMDPIpt_PT
dc.relationCenter for Health Technology and Services Research
dc.relationHealth Research Network: From Lab to Community Health
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectCarotid endarterectomypt_PT
dc.subjectCarotid stenosispt_PT
dc.subjectMajor adverse cardiovascular eventspt_PT
dc.subjectSurvival analysispt_PT
dc.subjectMICA scorept_PT
dc.subjectAtherosclerosispt_PT
dc.subjectPerioperative strokept_PT
dc.titleThe Gupta perioperative risk for myocardial infarct or cardiac arrest (MICA) calculator as an intraoperative neurologic deficit predictor in carotid endarterectomypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.awardTitleCenter for Health Technology and Services Research
oaire.awardTitleHealth Research Network: From Lab to Community Health
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/6817 - DCRRNI ID/UIDB%2F04255%2F2020/PT
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/6817 - DCRRNI ID/LA%2FP%2F0053%2F2020/PT
oaire.citation.issue21pt_PT
oaire.citation.startPage6367pt_PT
oaire.citation.titleJournal of Clinical Medicinept_PT
oaire.citation.volume11pt_PT
oaire.fundingStream6817 - DCRRNI ID
oaire.fundingStream6817 - DCRRNI ID
person.familyNameFernandes
person.familyNameMarreiros
person.givenNameBeatriz
person.givenNameAna
person.identifier.ciencia-id9A12-9450-7051
person.identifier.orcid0000-0002-9632-3992
person.identifier.orcid0000-0001-9410-4772
person.identifier.scopus-author-id57194785077
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.nameFundação para a Ciência e a Tecnologia
project.funder.nameFundação para a Ciência e a Tecnologia
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication09a5a810-ee48-4961-9771-2618779e0879
relation.isAuthorOfPublicationc0a8e5da-26ae-42a8-ab04-fa4df4356375
relation.isAuthorOfPublication.latestForDiscoveryc0a8e5da-26ae-42a8-ab04-fa4df4356375
relation.isProjectOfPublication58b2d36c-a8f1-4f5c-8512-a501deb47eb8
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