Journal
HEART LUNG AND CIRCULATION
Volume 27, Issue 2, Pages 260-266Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.hlc.2017.02.012
Keywords
Delirium; Older patients; TAVI; Qualitative method
Categories
Funding
- Department of Heart Disease, Haukeland University Hospital
Ask authors/readers for more resources
Background Surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI) are increasingly performed in octogenarian patients with severe aortic stenosis (AS), including those with high surgical risk. Postoperative delirium (PD) is a common and serious complication in older patients, characterised by reduced awareness, change in consciousness, disturbance in logical thinking and hallucinations. Methods To explore how octogenarian patients experienced PD, a qualitative study was conducted including five women and five men between 81 and 88 years. The incidence of PD was assessed for five days using the Confusion Assessment Method. Cognitive function was assessed preoperatively and at a 6-month follow-up using the Mini-Mental State Examination. In-depth interviews were conducted 6-12 months postdischarge, transcribed, and analysed using Giorgi's phenomenological method. Results Postoperative delirium experiences were grouped into six themes: Like dreaming while awake, Disturbed experiences of time, Existing in a twilight zone, Trapped in medical tubes, Moving between different surroundings and Meeting with death and the deceased. Conclusions For the first time, we show that octogenarian patients who undergo SAVR or TAVI have strong and distressing memories of their delirious state that can persist for up to 12 months later. These findings provide valuable new information that will likely improve delivery of health services and enhance professional and empathic care of octogenarians after SAVR and TAVI.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available