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Type: Journal article
Title: Meta-analysis of prevalence and risk factors for delirium after transcatheter aortic valve implantation
Author: Tilley, E.
Psaltis, P.
Loetscher, T.
Davis, D.
Harrison, S.
Kim, S.
Keage, H.
Citation: American Journal of Cardiology, 2018; 122(11):1917-1923
Publisher: Elsevier
Issue Date: 2018
ISSN: 0002-9149
Statement of
Erica Tilley, Peter J. Psaltis, Tobias Loetscher, Daniel H. Davis, Stephanie L. Harrison, Susan Kim and Hannah A.D. Keage
Abstract: Delirium is a severe and common complication following transcatheter aortic valve implantation (TAVI). We sought to identify the prevalence and risk factors associated with the development of postprocedural delirium in patients aged over 60 years who underwent elective TAVI for aortic stenosis. Overall, 1,051 articles were searched, from which 9 studies were included. The prevalence of delirium following TAVI was higher in studies that assessed delirium for a minimum of 3 consecutive days (24.9%) compared with the studies that did not (2%). There were large effect sizes (d > 0.8) for 3 risk factors: acute kidney injury (odds ratio [OR] 5, p < 0.001), transapical approach (OR 4, p < 0.001) and carotid artery disease (OR 4, p < 0.001), whilst small effect sizes were found for a history of atrial fibrillation, prior stroke/transient ischemic attack, peripheral artery disease, hypertension, and prior cognitive impairment. In conclusion, 23% of patients 60 years and over who underwent TAVI experience delirium, a preventative cause of cognitive impairment and dementia. Recognition of risk factors for delirium after TAVI, such as a history of carotid artery disease, development of acute kidney injury, or use of a transapical approach, provides an opportunity to implement proven delirium preventative measures.
Keywords: Humans; Delirium; Aortic Valve Stenosis; Postoperative Complications; Prevalence; Risk Assessment; Risk Factors; Global Health; Transcatheter Aortic Valve Replacement
Rights: © 2018 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license. ( )
RMID: 0030099843
DOI: 10.1016/j.amjcard.2018.08.037
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