Postoperative delirium in individuals undergoing transcatheter aortic valve replacement: a systematic review and meta‐analysis

• Autores: 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
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 66, Nº. 12, 2018, págs. 2417-2424
• Idioma: inglés
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• Resumen

  • 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.