当前位置： SCI文献检索 > JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA期刊下所有文献 > Delirium Following Transcatheter Aortic Valve Replacement: National Inpatient Sample Analysis.

Delirium Following Transcatheter Aortic Valve Replacement: National Inpatient Sample Analysis.

Abstract：

OBJECTIVE:To investigate the risk factors for postoperative delirium and the impact of delirium on mortality and morbidity following transcatheter aortic valve implantation (TAVI). DESIGN:Patients who underwent TAVI were identified using the International Classification of Diseases, 9th revision clinical modification codes from the National Inpatient Sample database. Statistical analysis of preoperative and perioperative risk factors was done to identify the independent risk factors for delirium after TAVI. SETTING:Multi-institutional. PARTICIPANTS:Patients who underwent TAVI from 2012 to 2013. INTERVENTIONS:TAVI. MEASUREMENTS AND MAIN RESULTS:Over the period of 2 years (2012-2013), 7,566 patients underwent TAVI. The incidence of delirium post-TAVI was 4.57% (345). Age >85 (odds ratio [OR] 1.03; 95% confidence interval [CI] 1.01-1.05; p = 0.003), electrolyte abnormalities (OR 1.83; 95% CI 1.17-2.87; p = 0.008), prior neurologic illness (OR 1.67; 95% CI 1.10-3.15; p = 0.01), and weight loss in the hospital (OR 1.77; 95% CI 1.05-2.99; p = 0.03) were independent risk factors for postoperative delirium (POD). Unilateral or bilateral carotid stenosis did not predispose to the development of delirium. POD was an independent risk factor for procedural morbidity (OR 3.29; 95% CI 2.05-5.28; p < 0.001). POD did not increase the risk of in-house mortality after TAVI. CONCLUSION:Age of >85, electrolyte disturbance, pre-existing neurologic disease and weight loss were found to be independent risk factors for delirium. POD was associated significantly with morbidity. Owing to a significant increase in the morbidity, a thorough screening protocol and effective strategies to predict, prevent, and treat postoperative delirium would reduce the cost associated with TAVI.

journal_name

J Cardiothorac Vasc Anesth

journal_title

Journal of cardiothoracic and vascular anesthesia

authors

Soundhar A,Udesh R,Mehta A,Schindler J,Jeevanantham V,Gleason T,Thirumala PD

doi

10.1053/j.jvca.2017.03.016

subject

Has Abstract

pub_date

2017-12-01 00:00:00

pages

1977-1984

issue

eissn

1053-0770

issn

1532-8422

pii

S1053-0770(17)30292-6

journal_volume

pub_type

杂志文章,多中心研究

在线工具

Delirium Following Transcatheter Aortic Valve Replacement: National Inpatient Sample Analysis.