Postoperative Delirium in Individuals Undergoing Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis

Masieh Abawi, Matteo Pagnesi, Pierfrancesco Agostoni, Mauro Chiarito, Romy C. van Jaarsveld, Charlotte S. van Dongen, Arjen J.C. Slooter, Antonio Colombo, Nynke H.M. Kooistra, Pieter A.F.M. Doevendans, Azeem Latib, Pieter R. Stella

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

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%; pheterogeneity <.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.

Original languageEnglish (US)
Pages (from-to)2417-2424
Number of pages8
JournalJournal of the American Geriatrics Society
Volume66
Issue number12
DOIs
StatePublished - Dec 2018
Externally publishedYes

Keywords

  • TAVR
  • cognition
  • delirium
  • transcatheter aortic valve replacement

ASJC Scopus subject areas

  • Geriatrics and Gerontology

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