Meta-analysis of Prevalence and Risk Factors for Delirium After Transcatheter Aortic Valve Implantation
Key result
Postprocedural delirium affects 23% of patients >60 years undergoing TAVI, with acute kidney injury (OR 5), transapical approach (OR 4), and carotid artery disease (OR 4) as major risk factors.
Population
Patients aged over 60 years who underwent elective transcatheter aortic valve implantation for aortic…
Design
Meta-analysis
Follow-up
Hospital stay to 6 months postoperatively
Authors
Discussion
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Implication
May warrant routine post-TAVI delirium screening in older adults; leaves open whether targeting AKI or access site reduces incidence.
Study Design
Type
Meta-Analysis
Structured PICO
P
Population
Meta-analysis of 9 studies evaluating patients aged over 60 years who underwent elective TAVI for aortic stenosis to determine the prevalence and risk factors for postprocedural delirium.
E
Exposure
Transcatheter aortic valve implantation (TAVI)
O
Outcome
Period prevalence of delirium identified using a standardized method such as the Confusion Assessment Method (CAM) or the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV)safety
Main Result
Odds Ratio: 5
p-value: p=<0.001
Delirium affects nearly 1 in 4 older adults following TAVI, with acute kidney injury, transapical approach, and carotid artery disease being strong predictors.
Limitations
- Only included studies published in English
- No studies were adequately powered to detect prevalence of delirium
- Methodological quality of the studies was relatively mediocre (mean score 5 of 9)
Cite This Study
Tilley et al. (2018) conducted a meta-analysis in Aortic stenosis. Acute kidney injury, transapical approach, and carotid artery disease vs. Absence of these risk factors was evaluated on Postprocedural delirium (OR 5, p=<0.001). Postprocedural delirium affects 23% of patients >60 years undergoing TAVI, with acute kidney injury (OR 5), transapical approach (OR 4), and carotid artery disease (OR 4) as major risk factors.