Your browser doesn't support javascript.
loading
Does Comprehensive Geriatric Assessment Reduce the Incidence of Postoperative Delirium? A Quasi-experimental Study in Older Adults Undergoing Transcatheter Aortic Valve Implantation.
Schwesinger, Anna; Tsai, Li-Tang; Lang, Wei; Mantegazza, Noemi; Bauernschmitt, Robert; Wilhelm, Markus Johannes; Bischoff-Ferrari, Heike Annette; Gagesch, Michael.
Afiliación
  • Schwesinger A; Center on Aging and Mobility, University of Zurich, Zurich, Switzerland.
  • Tsai LT; Center on Aging and Mobility, University of Zurich, Zurich, Switzerland.
  • Lang W; Center on Aging and Mobility, University of Zurich, Zurich, Switzerland.
  • Mantegazza N; Center on Aging and Mobility, University of Zurich, Zurich, Switzerland.
  • Bauernschmitt R; Clinic for Cardiac Surgery, University Hospital Zurich, Zurich, Switzerland.
  • Wilhelm MJ; Clinic for Cardiac Surgery, University Hospital Zurich, Zurich, Switzerland.
  • Bischoff-Ferrari HA; Center on Aging and Mobility, University of Zurich, Zurich, Switzerland.
  • Gagesch M; Department of Geriatrics and Aging Research, University of Zurich, Zurich, Switzerland.
Clin Interv Aging ; 19: 347-355, 2024.
Article en En | MEDLINE | ID: mdl-38434577
ABSTRACT

Purpose:

Postoperative delirium (POD) after transcatheter aortic valve implantation (TAVI) is frequent in older adults and associated with multiple negative outcomes including a higher mortality. We aimed to investigate whether a comprehensive geriatric assessment (CGA) prior to TAVI reduces the odds of POD and results in a positive change in self-care ability, intended to lay a foundation for future geriatric comanagement. Patients and

methods:

We used a retrospective, single-center study with a quasi-experimental design enrolling patients aged 70 years and older undergoing CGA before elective TAVI, and a nonrandomized comparison group without preoperative CGA. Data on POD occurrence during the first 5 days after TAVI (primary outcome) and change in self-care ability index (SPI) between admission and discharge (secondary outcome) were collected from electronic health records and CGA data (exposure) by clinical assessment. To explore associations between (1) CGA and POD, and (2) CGA and SPI, multivariate logistic regression and linear regression models were applied adjusting for age, sex, BMI, and number of medications.

Results:

Among 435 patients (mean age 81.0 ± 5.6 years, 43.6% women, median [IQR] SPI at baseline 40 [39, 40] points), POD incidence was 14.3% in the CGA group vs 18.8% in the non-CGA group (P 0.219). Undergoing CGA before TAVI was not associated with the odds for POD (OR 1.15; 95%CI 0.65-2.04) or improved SPI (P 0.073).

Conclusion:

We observed no association of CGA prior to TAVI with POD incidence or postoperative self-care, highlighting the need for additional studies investigating the effect of POD preventive measures in older TAVI patients integrated into a comprehensive geriatric comanagement program.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Reemplazo de la Válvula Aórtica Transcatéter / Delirio del Despertar Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Clin Interv Aging Asunto de la revista: GERIATRIA Año: 2024 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Nueva Zelanda
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Reemplazo de la Válvula Aórtica Transcatéter / Delirio del Despertar Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Clin Interv Aging Asunto de la revista: GERIATRIA Año: 2024 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Nueva Zelanda