Delirium Following Transcatheter Aortic Valve Replacement: National Inpatient Sample Analysis

Objective To investigate the risk factors for post-operative delirium and the impact of delirium on mortality and morbidity following transcatheter aortic valve implantation (TAVI). Design Patients who underwent TAVI were identified using ICD-9 CM codes from National Inpatient Sample database. Statistical analysis of pre-operative and perioperative risk factors was done to identify the independent risk factors for delirium after TAVI. Setting Multi-Institutional Participants Patients who underwent TAVI from 2012-2013 Interventions Trasncatheter aortic valve implantation Measurements and Main Results Over the period of 2 years (2012-2013), 7566 patients underwent TAVI. The incidence of delirium post TAVI, was 4.57 %( 345). Age>85 (OR-1.03; 95% CI- 1.01-1.05; p-0.003), dyselectrolytemia (OR- 1.83; 95% CI -1.17- 2.87; p-0.008), prior neurological illness (OR- 1.67; 95% CI- 1.10-3.15; p- 0.01) and weight loss in the hospital (OR- 1.77; 95% CI- 1.05 – 2.99; p-0.03) and were independent risk factors for POD. Unilateral or bilateral carotid stenosis did not predispose to the development of delirium. POD was an independent risk factor for procedural morbidity (OR-3.29; 95% CI -2.05- 5.28; p85, electrolyte disturbance, preexisting neurological disease andweight loss were found to be independent risk factors for delirium. POD was significantly associated with morbidity. Owing to a significant increase in the morbidity, a thorough screening protocol and effective strategies to predict, prevent and treat post-operative delirium, would reduce the cost associated with TAVI.