Academic Journal
Periinterventional inflammation and blood transfusions predict postprocedural delirium after percutaneous repair of mitral and tricuspid valves
| Title: | Periinterventional inflammation and blood transfusions predict postprocedural delirium after percutaneous repair of mitral and tricuspid valves |
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| Authors: | Körber, Maria I., Schäfer, Matthieu, Vimalathasan, Rakave, Mauri, Victor, Iliadis, Christos, Metze, Clemens, Freyhaus, Henrik ten, Rudolph, Volker, Baldus, Stephan, Pfister, Roman |
| Source: | Clin Res Cardiol |
| Publisher Information: | Springer Science and Business Media LLC, 2021. |
| Publication Year: | 2021 |
| Subject Terms: | Male, Cardiac Catheterization, Time Factors, Heart Valve Diseases, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Risk Factors, Germany, Preoperative Care, Humans, Blood Transfusion, Prospective Studies, Aged, 80 and over [MeSH], Aged [MeSH], Postoperative Complications/epidemiology [MeSH], Delirium/epidemiology [MeSH], Risk Factors [MeSH], Preoperative Care/methods [MeSH], Germany/epidemiology [MeSH], Male [MeSH], Postoperative Complications/etiology [MeSH], Tricuspid Valve/surgery [MeSH], Heart Valve Prosthesis Implantation/methods [MeSH], Female [MeSH], Follow-Up Studies [MeSH], Humans [MeSH], Prospective Studies [MeSH], Treatment Outcome [MeSH], Cardiac Catheterization/methods [MeSH], Incidence [MeSH], MitraClip, Time Factors [MeSH], Delirium, Blood Transfusion/methods [MeSH], Original Paper, Prognosis [MeSH], Delirium/etiology [MeSH], Heart Valve Diseases/surgery [MeSH], Mitral Valve/surgery [MeSH], Percutaneous repair of atrioventricular valves, Aged, Aged, 80 and over, Heart Valve Prosthesis Implantation, 2. Zero hunger, Incidence, Prognosis, 3. Good health, Mitral Valve, Female, Follow-Up Studies |
| Description: | Objectives The aim of this study was to examine predictors and impact of postoperative delirium (POD) on outcome after percutaneous repair of mitral and tricuspid valves. Background POD is common in elderly patients and contributes to increased health care costs and worse outcome. Predictors of POD in percutaneous mitral or tricuspid valve procedures are unclear. Methods In a prospective single-center study, patients were screened for POD using the Confusion Assessment Method on the first and second postprocedural days, and up until 7 days in patients with clinical suspicion of delirium. Associations of POD with baseline characteristics, periprocedural outcome and mid-term mortality were examined. Results One hundred and seventy-seven patients were included (median age 78 years [72–82], 41.8% female) and median (IQR) follow-up was 489 (293–704) days. Patients developing POD (n = 16, 9%) did not differ in baseline and procedural characteristics but more often received postinterventional blood transfusions (37.5% vs. 9.9%, p value = 0.007) and suffered from infections (43.8% vs. 9.9%, p value = 0.001). Patients with POD showed worse survival (HR: 2.71 [1.27–5.78]; p = 0.01), with an estimated 1-year survival of 46 ± 13% compared to 80 ± 3% in patients without POD (log-rank p value 0.007). In multivariate Cox regression, POD remained a significant predictor of mid-term mortality (HR 4.75 [1.97–11.5]; p = 0.001). Conclusion After percutaneous mitral or tricuspid valve repair, POD was independently associated with worse mid-term survival. Procedure- rather than patient-associated characteristics such as blood transfusions and infections emerged as important risk factors for development of POD. Considering the substantial prognostic impact of POD, further studies on its prevention are warranted to improve patient outcome. |
| Document Type: | Article Other literature type |
| Language: | English |
| ISSN: | 1861-0692 1861-0684 |
| DOI: | 10.1007/s00392-021-01886-z |
| Access URL: | https://link.springer.com/content/pdf/10.1007/s00392-021-01886-z.pdf https://pubmed.ncbi.nlm.nih.gov/34061227 https://link.springer.com/content/pdf/10.1007/s00392-021-01886-z.pdf https://europepmc.org/article/MED/34061227 https://pubmed.ncbi.nlm.nih.gov/34061227/ https://www.ncbi.nlm.nih.gov/pubmed/34061227 http://www.ncbi.nlm.nih.gov/pubmed/34061227 https://link.springer.com/article/10.1007/s00392-021-01886-z https://repository.publisso.de/resource/frl:6450908 |
| Rights: | CC BY URL: http://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (http://creativecommons.org/licenses/by/4.0/) . |
| Accession Number: | edsair.doi.dedup.....7b50dc2d0c98dea2ec6bcdea6ca16de5 |
| Database: | OpenAIRE |
| ISSN: | 18610692 18610684 |
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| DOI: | 10.1007/s00392-021-01886-z |