Abstract 14220: Incidence of Delirium After Transcatheter Aortic Valve Replacement

Abstract

Introduction: Patients who undergo transcatheter aortic valve replacement (TAVR) often are elderly, frail and with comorbid conditions. Delirium is frequently encountered in older adults and is associated with increased morbidity and mortality. Hypothesis: The purpose of this study is to determine the clinical significance of postoperative delirium in patients with aortic stenosis undergoing TAVR. Methods: The National Inpatient Sample was queried from 2011-2019 for relevant ICD-9 and ICD-10 codes to identify patients who underwent TAVR. Baseline characteristics and in-hospital outcomes between patients with and without delirium were compared. Logistic regression was performed to adjust for pre-specified co-variates for mortality and other in-hospital outcomes. p-value was considered significant when <0.001. Results: We identified a weighted sample of 270,178 patients who underwent TAVR, of which 5,059 (1.9%) had a diagnosis of delirium. Baseline characteristics are shown in Table 1. Patients who had delirium after TAVR had a higher mortality risk (3% vs 1.8%), had a longer LOS (median 7 vs 3 days) and higher expenditures (median $220,046 vs $179,166, p<0.001 for all). When adjusted for significant comorbidities, the odds ratio (OR) for mortality was 1.303 (CI [1.1-1.5]) with a LOS OR of 1.065 (CI [1.062-1.068], p<0.001 for both. Conclusions: Delirium after TAVR is associated with higher in-hospital mortality, prolonged hospital stay and higher hospital expenditures. A structured approach focused on prevention and early recognition of delirium may be warranted.