Neuroanesthesia & neurocritical care
Cerebral oximetry index indicates delirium or stroke after carotid endarterectomy: An observational study
Authors' conclusion
COx is a promising metric for predicting postoperative delirium or new-onset overt stroke in patients having CEA. The optimal COx threshold was 0.7 in the pre-clamping phase and 0.4 in the post-clamping phase.
Study context
- Population
- Patients scheduled for carotid endarterectomy (CEA)
- Participants
- 140 patients
- Outcome
- Composite of:
- Postoperative delirium or new-onset overt stroke
- Predicted by COx threshold (ROC curve, Youden's index)
Methodological detailspost hoc subgroup analyses
- Post hoc subgroup analyses
Main finding
As reported in the abstract
Prediction of postoperative delirium or new-onset overt stroke by COx > 0.6
- AUC
- 0.69
- Youden index
- 0.61
- P
- P = 0.0003
- PPV
- 100 %
Observational data: associations, not effects.
Further findings
Before clamping: risk with COx > 0.7 for 20 min (subgroup)
| OR (95 % CI) | ||
|---|---|---|
| COx > 0.7 for 20 minGreatest increase in risk · post hoc subgroup analysis | 3.10 (2.20–3.78) | |
| 0.20.5125Odds ratio (log scale) |
Incidence of delirium
- Delirium (15/140)
- 10.7 %
Incidence of stroke
- Stroke (5/140)
- 3.6 %
- Including 1 patient who had both
During clamping (subgroup)
- COx not predictive during clamping
- Post hoc subgroup analysis
After clamping: optimal COx threshold 0.4 (subgroup)
- AUC
- 0.85
- Youden index
- 0.82
- P
- P < 0.0001
- PPV
- 100 %
- Post hoc subgroup analysis
Original publication
Cerebral oximetry index indicates delirium or stroke after carotid endarterectomy: An observational study. J Clin Anesth. Published 24 December 2024. doi:10.
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