Universität zu Köln

Koerber, Maria I., Schafer, Matthieu ORCID: 0000-0003-1875-1163, Vimalathasan, Rakave, Mauri, Victor, Iliadis, Christos, Metze, Clemens, Freyhaus, Henrik ten, Rudolph, Volker, Baldus, Stephan and Pfister, Roman (2021). Periinterventional inflammation and blood transfusions predict postprocedural delirium after percutaneous repair of mitral and tricuspid valves. Clin. Res. Cardiol., 110 (12). S. 1921 - 1930. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1861-0692

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Abstract

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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Koerber, Maria I. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schafer, Matthieu UNSPECIFIED orcid.org/0000-0003-1875-1163 UNSPECIFIED Vimalathasan, Rakave UNSPECIFIED UNSPECIFIED UNSPECIFIED Mauri, Victor UNSPECIFIED UNSPECIFIED UNSPECIFIED Iliadis, Christos UNSPECIFIED UNSPECIFIED UNSPECIFIED Metze, Clemens UNSPECIFIED UNSPECIFIED UNSPECIFIED Freyhaus, Henrik ten UNSPECIFIED UNSPECIFIED UNSPECIFIED Rudolph, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-573738
DOI:	10.1007/s00392-021-01886-z
Journal or Publication Title:	Clin. Res. Cardiol.
Volume:	110
Number:	12
Page Range:	S. 1921 - 1930
Date:	2021
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1861-0692
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CONFUSION ASSESSMENT METHOD; POSTOPERATIVE DELIRIUM; FUNCTIONAL DECLINE; HEART-FAILURE; IMPACT; RISK; ASSOCIATION; RELIABILITY; MORTALITY; VALIDITY Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/57373