TY - JOUR
T1 - Postoperative Delirium in Individuals Undergoing Transcatheter Aortic Valve Replacement
T2 - A Systematic Review and Meta-Analysis
AU - Abawi, Masieh
AU - Pagnesi, Matteo
AU - Agostoni, Pierfrancesco
AU - Chiarito, Mauro
AU - van Jaarsveld, Romy C.
AU - van Dongen, Charlotte S.
AU - Slooter, Arjen J.C.
AU - Colombo, Antonio
AU - Kooistra, Nynke H.M.
AU - Doevendans, Peter A.F.M.
AU - Latib, Azeem
AU - Stella, Pieter R.
N1 - Funding Information:
Conflict of Interest: Dr. A. Latib is a consultant for Medtronic, Abbott Vascular, ICS, and Keystone Heart. None of the other authors have a conflict of interest regarding the data or subject matter reported in this study. Author Contributions: Abawi: study concept and design, data collection, interpretation of data, preparation and revision of manuscript. Pagnesi: study concept and design, data analysis, preparation and revision of manuscript. Agostoni, Slooter, Colombo, Kooistra, Doevendans, Latib: revision of manuscript. Chiarito: data analysis, revision of manuscript. van Jaarsveld, van Dongen: data collection, revision of manuscript. Stella: preparation of manuscript, principle investigator of study.
Publisher Copyright:
© 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society
PY - 2018/12/1
Y1 - 2018/12/1
N2 - Objectives: To evaluate the incidence of in-hospital postoperative delirium (IHPOD) after transcatheter aortic valve replacement (TAVR). Design: Systematic review and meta-analysis. Setting: Elective procedures. Participants: Individuals undergoing TAVR. Measurements: A literature search was conducted in PubMed, Embase, BioMedCentral, Google Scholar, and the Cochrane Central Register of Controlled Trials (up to December 2017). All observational studies reporting the incidence of IHPOD after TAVR (sample size > 25) were included in our meta-analysis. The reported incidence rates were weighted to obtain a pooled estimate rate with 95% confidence interval (CI). Results: Of 96 potentially relevant articles, 31 with a total of 32,389 individuals who underwent TAVR were included in the meta-analysis. The crude incidence of IHPOD after TAVR ranged from 0% to 44.6% in included studies, with a pooled estimate rate of 8.1% (95% CI=6.7–9.4%); heterogeneity was high (Q = 449; I = 93%; p
heterogeneity <.001). The pooled estimate rate of IHPOD was 7.2% (95% CI=5.4–9.1%) after transfemoral (TF) TAVR and 21.4% (95% CI=10.3–32.5%) after non-TF TAVR. Conclusion: Delirium occurs frequently after TAVR and is more common after non-TF than TF procedures. Recommendations are made with the aim of standardizing future research to reduce heterogeneity between studies on this important healthcare problem. J Am Geriatr Soc 66:2417–2424, 2018.
AB - Objectives: To evaluate the incidence of in-hospital postoperative delirium (IHPOD) after transcatheter aortic valve replacement (TAVR). Design: Systematic review and meta-analysis. Setting: Elective procedures. Participants: Individuals undergoing TAVR. Measurements: A literature search was conducted in PubMed, Embase, BioMedCentral, Google Scholar, and the Cochrane Central Register of Controlled Trials (up to December 2017). All observational studies reporting the incidence of IHPOD after TAVR (sample size > 25) were included in our meta-analysis. The reported incidence rates were weighted to obtain a pooled estimate rate with 95% confidence interval (CI). Results: Of 96 potentially relevant articles, 31 with a total of 32,389 individuals who underwent TAVR were included in the meta-analysis. The crude incidence of IHPOD after TAVR ranged from 0% to 44.6% in included studies, with a pooled estimate rate of 8.1% (95% CI=6.7–9.4%); heterogeneity was high (Q = 449; I = 93%; p
heterogeneity <.001). The pooled estimate rate of IHPOD was 7.2% (95% CI=5.4–9.1%) after transfemoral (TF) TAVR and 21.4% (95% CI=10.3–32.5%) after non-TF TAVR. Conclusion: Delirium occurs frequently after TAVR and is more common after non-TF than TF procedures. Recommendations are made with the aim of standardizing future research to reduce heterogeneity between studies on this important healthcare problem. J Am Geriatr Soc 66:2417–2424, 2018.
KW - cognition
KW - delirium
KW - TAVR
KW - transcatheter aortic valve replacement
KW - Transcatheter Aortic Valve Replacement
KW - Humans
KW - Risk Factors
KW - Treatment Outcome
KW - Incidence
KW - Postoperative Complications/epidemiology
KW - Aortic Valve Stenosis/surgery
KW - Aortic Valve/surgery
KW - Risk Assessment/methods
KW - Delirium/diagnosis
UR - https://www.scopus.com/pages/publications/85054556180
U2 - 10.1111/jgs.15600
DO - 10.1111/jgs.15600
M3 - Review article
C2 - 30296342
SN - 0002-8614
VL - 66
SP - 2417
EP - 2424
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 12
ER -