МЕДИКО-СОЦІАЛЬНА ОЦІНКА СТАНУ ПАЦІЄНТІВ З АТЕРОСКЛЕРОТИЧНИМИ УРАЖЕННЯМИ СОННИХ АРТЕРІЙ

Combining several assessment methods (functional independence, psycho-emotional and cognitive state, medical and social factors, cardiovascular risk, hereditary history) is critically important, since carotid atherosclerosis is a systemic disease with a multi-vector impact. The study aims to optimize the system for assessing medical, social, and sociodemographic characteristics in patients with carotid atherosclerosis using validated survey instruments. At the Neurological Pathology Diagnostic Center of the MNPE "Regional Clinical Hospital of the Ivano-Frankivsk Regional Council" for 2022-2024, 84 male individuals were examined. Of these, the study group consisted of 44 patients with clinical signs of carotid atherosclerosis. Forty patients with asymptomatic atherosclerotic lesions of the carotid arteries were selected for the comparison group. The age of men in both cohorts was 50-79 years. The Framingham risk scale for the development of cardiovascular events over the next 10 years was used to assess the medical and social factors of influence. Possible neurological deficit was evaluated according to the results of the National Institutes of Health (NIH) stroke scale for a group of symptomatic patients. Self-care ability was also evaluated according to the 10-point Barthel index. The patient health questionnaire (PHQ-9) was used to assess the psychoemotional state, and the Montreal Cognitive Test (MoCA) was used to analyze cognitive function. The most common comorbidities in both samples were: arterial hypertension – 87,0 %, diabetes mellitus type 2 – 32,1 %, ischemic heart disease – 59,5 %. Smoking was significantly more common in 35 (79,5 %) people from the study group, and a family history of cardiovascular diseases was present in 36 (81,8 %). When testing according to the NIH scale, almost all individuals in the group of symptomatic patients had zero points, with some exceptions, where a few men noted weakness in the legs or mild loss of sensitivity. Alarming complaints in symptomatic patients were short-term loss of consciousness, memory, and vision impairment, decreased skin sensitivity, and decreased vocabulary (according to their own observations), which was the argument for adding an NIH assessment for this category of individuals. According to the Barthel scale, an inverse relationship was observed in both samples between the age of the patients and the ability to perform basic daily activities. In the study group, 32 (72,7 %) and in the comparison group, 25 (62,5 %) individuals showed decreased cognitive functions at 21-25 points. Signs of depression were detected in 29 (65,9 %) men in the study group and 21 (52,5 %) patients in the comparison group. Conclusions. In symptomatic patients with carotid atherosclerosis, a significant influence of the smoking factor (p=0,035) and family history of cardiovascular diseases (p=0,005) was found. In patients of both groups, when assessing functional independence, a decrease in the Barthel index with increasing age was determined, and by using validated scales that allow increasing the reliability of data assessment, patients with decreased cognitive functions and manifestations of depression were identified.