title: Changes in health-related quality of life after carotid endarterectomy.
abstract: OBJECTIVE
  Carotid endarterectomy (CEA) is intended to prevent stroke and therefore to extend lifespan. Whether CEA also influences health-related quality of life (HRQOL) is largely unknown. This study aimed to assess HRQOL-changes after CEA.
  
  
  METHODS
  Prospective study, data assessment within 1 week before and 3 months after CEA.
  
  
  METHODS
  Patient classification (n = 70) was based on presenting neurological symptoms (none (24), transient (26), or permanent (20)), patency or occlusion (27%) of the contralateral internal carotid artery and intraoperative shunt requirement (28%).
  
  
  METHODS
  HRQOL was investigated with the Sickness Impact Profile (SIP). Analysis of variance was used to adjust for the influence of preoperative differences in functional impairment and comorbidity on the changes found.
  
  
  RESULTS
  Preoperative findings showed that the SIP scores of stroke patients and shunted patients were significantly higher (indicating poorer HRQOL) than those of the other patients. No adverse effect of CEA was observed. Analysis of variance revealed that neurological classification was not reflected to HRQOL changes. However, patients with contralateral occlusion showed a significant postoperative improvement (f = 4.99, p < 0.05).
  
  
  CONCLUSIONS
  HRQOL improvement after CEA is restricted to patients with occlusion of the contralateral carotid artery. Assessment of outcome of CEA should be related not only to neurological classification, but also to haemodynamic factors such as contralateral occlusion.
authors.affiliation: Department of Clinical Neurophysiology, University Hospital Utrecht, The Netherlands.
authors.forename: E M
authors.initials: EM
authors.lastname: Vriens
authors.forename: M W
authors.initials: MW
authors.lastname: Post
authors.forename: H M
authors.initials: HM
authors.lastname: Jacobs
authors.forename: A C
authors.initials: AC
authors.lastname: van Huffelen
authors.forename: B C
authors.initials: BC
authors.lastname: Eikelboom
mesh_terms: D000368:Aged; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D018434:Sickness Impact Profile