Postoperative delirium is associated with increased intensive care unit and hospital length of stays after liver transplantation

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• 作者：Bishwajit Bhattacharya ; MD ; FACS^a ; ^{bishwajit.bhattacharya@yale.edu} ; Adrian Maung ; MD ; FACS^a ; Kimberly Barre ; RN^a ; Linda Maerz ; MD ; FACS^a ; Manuel I. Rodriguez-Davalos ; MD ; FACS^b ; Michael Schilsky ; MD^b ; David C. Mulligan ; MD ; FACS^b ; Kimberly A. Davis ; MD ; FACS^a
• 关键词：Liver transplant ; Delirium ; Complication
• 刊名：Journal of Surgical Research
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：207
• 期：Complete
• 页码：223-228
• 全文大小：317 K
• 卷排序：207

文摘

Delirium is increasingly recognized as a common and important postoperative complication that significantly hinders surgical recovery. However, there is a paucity of data examining the incidence and impact of delirium after liver transplantation.MethodsRetrospective case series in a tertiary care center examining all (n = 144) adult patients who underwent liver transplantation during a 6-y period.ResultsDelirium occurred in 25% of the patients with an average duration of 4.56 d. Patients who developed delirium were older (P = 0.007), had higher preoperative model for end-stage liver disease score (P = 0.019) and longer pretransplant hospital length of stay (LOS; P = 0.003). Patients with delirium were also more likely to have alcohol ingestion as an etiology of the liver failure (P = 0.033). Delirious patients had a trend toward increased ventilator days (P = 0.235) and significantly longer postoperative hospital (P = 0.001) and intensive care unit LOS (P = 0.001). Delirium was also associated with an increased frequency of hospital acquired infections including urinary tract infections (P = 0.005) and pneumonias (P = 0.001).ConclusionsDelirium is a common occurrence among liver transplant patients associated with increased complications and LOSs. Further prospective studies are needed to determine the specific risk factors in this complex population and to determine if delirium has an impact on long-term outcomes.