Delirium after surgical and transcatheter aortic valve replacement is associated with increased mortality

The Journal of Thoracic and Cardiovascular Surgery
Hersh S ManiarAlan Zajarias

Abstract

The purpose of this study was to determine the incidence and clinical significance of postoperative delirium (PD) in patients with aortic stenosis undergoing surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR). Between 2010 and 2013, 427 patients underwent TAVR (n = 168) or SAVR (n = 259) and were screened for PD using the Confusion Assessment Method for the Intensive Care Unit. The incidence of PD in both treatment groups was determined and its association with morbidity and mortality was retrospectively compared. PD occurred in 135 patients (32%) with a similar incidence between SAVR (33% [86 out of 259]) and TAVR (29% [49 out of 168]) (P = .40). TAVR by transfemoral approach had the lowest incidence of PD compared with SAVR (18% vs 33%; P = .025) or TAVR when performed by alternative access techniques (18% vs 35%; P = .02). Delirium was associated with longer initial intensive care unit stay (70 vs 27 hours), intensive care unit readmission (10% [14 out of 135] vs 2% [6 out of 292]), and longer hospital stay (8 vs 6 days) (P < .001 for all). PD was associated with increased mortality at 30 days (7% vs 1%; P < .001) and 1 year (21% vs 8%; P < .001). After multivariable adjustment, PD rema...Continue Reading

References

Jul 25, 2003·British Journal of Anaesthesia·R W D Nickalls, W W Mapleson
Apr 15, 2004·JAMA : the Journal of the American Medical Association·E Wesley ElyRobert S Dittus
Mar 23, 2006·Journal of the American Geriatrics Society·Josh F PetersonE Wesley Ely
Jun 6, 2007·Intensive Care Medicine·Pratik PandharipandeE Wesley Ely
Mar 30, 2010·Journal of the American Geriatrics Society·James L RudolphEdward R Marcantonio
Jun 7, 2011·The New England Journal of Medicine·Craig R SmithUNKNOWN PARTNER Trial Investigators
Oct 14, 2011·The Annals of Thoracic Surgery·Sandra KosterJob van der Palen
Oct 3, 2012·Journal of Neurosurgical Anesthesiology·Matthew T V ChanUNKNOWN CODA Trial Group
Jan 25, 2013·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Manuel WilbringUtz Kappert
Sep 3, 2013·The Journal of Nervous and Mental Disease·Michael B First
Jan 15, 2014·Anesthesia and Analgesia·Elizabeth L WhitlockMichael S Avidan
Sep 25, 2014·Critical Care Medicine·Irene J ZaalArjen J C Slooter
Oct 5, 2014·Journal of Cardiothoracic and Vascular Anesthesia·Benedikt Trabold, Thomas Metterlein
Oct 23, 2014·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Lurdes TseAlasdair M Barr
Dec 10, 2014·The Journal of Thoracic and Cardiovascular Surgery·Patrick JungRakesh C Arora

❮ Previous
Next ❯

Citations

Dec 29, 2015·The Journal of Thoracic and Cardiovascular Surgery·Hilary P Grocott
Jul 20, 2016·Revista española de geriatría y gerontología·Baldomero Álvarez-FernándezRicardo Gómez-Huelgas
Aug 16, 2016·Zeitschrift für Gerontologie und Geriatrie·F VogtJ Jessl
Oct 9, 2016·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·C RuggieroM L Brandi
Dec 19, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Michele GalloEnrico Ferrari
Oct 9, 2018·Journal of the American Geriatrics Society·Masieh AbawiPieter R Stella
Dec 15, 2018·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Brian J PotterSeth Clancy
Sep 28, 2018·Minerva cardioangiologica·Lucia JunqueraJosep Rodés-Cabau
Mar 19, 2019·Journal of the American Geriatrics Society·Sandra M ShiDae Hyun Kim
Apr 27, 2019·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Kellan E Ashley, William B Hillegass
Feb 12, 2020·Psychogeriatrics : the Official Journal of the Japanese Psychogeriatric Society·Zhaosheng JinMaurice Smith
Feb 25, 2020·Age and Ageing·Jeannette A GoudzwaardFrancesco U S Mattace-Raso
Dec 1, 2019·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Sandra B LauckUNKNOWN 3M TAVR Investigators, and Nursing and Allied Health Professional Site Leaders
Apr 15, 2018·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Peter StachonConstantin von Zur Mühlen
Jul 15, 2018·BMC Health Services Research·Maria SchubertAlain Rudiger
Feb 3, 2021·International Journal of Cardiology·Tania LuqueAna Viana-Tejedor
Aug 17, 2020·British Journal of Anaesthesia·Zhaosheng JinDaqing Ma
Sep 1, 2017·British Journal of Anaesthesia·A Aranake-Chrisinger, M S Avidan
Nov 7, 2020·JACC. Cardiovascular Interventions·Kees van der WulpNiels van Royen

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.