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Indwelling urinary catheters, aortic valve treatment and delirium: a prospective cohort study
  1. Leslie SP Eide1,
  2. Anette H Ranhoff2,3,
  3. Sandra Lauck4,5,
  4. Bengt Fridlund6,
  5. Rune Haaverstad2,6,
  6. Karl Ove Hufthammer7,
  7. Karel K J Kuiper6,
  8. Jan Erik Nordrehaug2,8,
  9. Tone Merete Norekvål1,2,6
  10. On behalf of the CARDELIR Investigators
  1. 1 Department of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
  2. 2 Department of Clinical Science, University of Bergen, Bergen, Norway
  3. 3 Kavli Research Center for Geriatrics and Dementia, Haraldsplass Hospital, Bergen, Norway
  4. 4 Centre for Heart Valve Innovation, St. Paul’s Hospital, Vancouver, Canada
  5. 5 University of British Columbia, Vancouver, Canada
  6. 6 Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
  7. 7 Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
  8. 8 Department of Cardiology, Stavanger University Hospital, Stavanger, Norway
  1. Correspondence to Dr Leslie SP Eide; leslieeide{at}hotmail.com

Abstract

Objectives To determine whether an association exists between delirium and length of time indwelling urine catheters (IUC) are used in octogenarian patients treated with surgical aortic valve treatment (SAVR) or transcatheter aortic valve implantation (TAVI).

Design Prospective cohort study.

Setting Tertiary university hospital covering the western region of Norway.

Participants Octogenarian patients undergoing elective SAVR or TAVI and willing to participate in the study were eligible. Patients unable to speak Norwegian were excluded. Between 2011 and 2013, 143 consecutive patients were included, and data from 136 of them are presented.

Primary outcome Delirium.

Results Logistic regression analysis shows that lower cognitive function was positively associated with delirium (OR 0.86, CI 0.74 to 0.99, p=0.047). Besides, the interaction term in the model shows that IUC use and delirium differed between SAVR and TAVI patients (p=0.04). The difference corresponded to a weaker association between hours of IUC use and delirium for SAVR (OR 1.01, CI: 0.99 to 1.03, p=0.54) compared with that for TAVI (OR 1.04, CI: 1.01 to 1.08, p=0.004).

Conclusions The association between IUC use and delirium is stronger for octogenarian patients treated with TAVI than for patients who received SAVR. Our results revealed a previously unknown association between the number of hours an IUC is used and postoperative delirium in octogenarian patients treated with TAVI.

  • delirium
  • TAVI
  • SAVR
  • octogenarian
  • urinary catheter

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Footnotes

  • Contributors LSPE, AHR, JEN, TMN: study concept and design. LSPE: data collection. LSPE, KOH, AHR, RH, BF, SL, KKJK, JEN, TMN: analysis and interpretation of data. LSPE, AHR, SL, BF, TMN: initial draft of manuscript. LSPE, AHR, BF, SL, RH, KOH, KKJK, JEN, TMN: critical revision of manuscript. LSPE, TMN and KOH had full access to all of the data (including statistical reports and tables) in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

  • Funding This work was supported by a full research grant from the University of Bergen to LSPE. The study also received funding from Western Norway University of Applied Sciences, the Norwegian Nurses Association, and Kavli Research Center for Geriatrics and Dementia.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Regional Committee for Ethics in Medical Research in Norway (REK Vest 2010/2936-6).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data available.

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