The problem of delirium following transcatheter aortic valve replacement

Abstract

Delirium is a common condition among elderly patients, particularly those hospitalized following surgical procedures. A study indicates that delirium occurs in 1 out of 5 patients following TAVR and it was found to be associated with diminished survival, prolonged hospitalization, and increased healthcare utilization. Delirium is potentially preventable and treatable clinical syndrome.

Incremental cost and length of stay associated with postprocedure delirium in transcatheter and surgical aortic valve replacement patients in the United States

“…Delirium is a complex clinical entity with both patient and situational factors appearing to play significant roles. While patient factors are unlikely to be modifiable for the most part, environmental factors can be optimized to reduce the risk of post‐AVR delirium.…”

“…In addition to being a psychological stress for both patients and families, delirium care in the elderly can be resource intensive and may prolong hospital or ICU length of stay (LoS) . For patients with severe aortic stenosis, TAVR is a less invasive procedure than SAVR and may have advantages in terms of reducing the likelihood of post‐AVR delirium in at risk patients . The purpose of this study was therefore to evaluate the independent incremental effect of post‐AVR delirium on hospital resource utilization in both endovascular TAVR and SAVR patients in the United States.…”

“…Patients with aortic stenosis requiring aortic valve replacement (AVR) tend to be elderly and may be at risk for delirium during hospitalization . Delirium following AVR has been associated with poorer functional status and long‐term survival following both surgical and transcatheter AVR (SAVR and TAVR, respectively) . In addition, a recent prospective cohort study found that delirium following elective cardiac surgery was independently associated with an increased risk of postdischarge major adverse cardiac events .…”