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Post-operative Delirium is Associated with Increased ICU and Hospital Length of Stays Following Liver Transplantation
*Bishwajit Bhattacharya, Adrian Maung, *Kimberly Barre, *Linda Maerz, *Manuel Rodriguez, Kimberly Davis
Yale School of Medicine, New Haven, CT
1. Objective: 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 following liver transplantation.
2. Design: Retrospective case series.
3. Setting: Tertiary care center.
4. Patients: All (n=144) adult patients who underwent liver transplantation at Yale New Haven Hospital during a six year period (2009-2014)
5. Interventions: None
6. Main Outcome Measures: Incidence of delirium, ventilator dependent days, ICU and hospital length of stay.
7. Results: Delirium occurred in 25% of the patients with an average duration of 4.56 days (IQR 3-5.75). Patients who developed delirium were older (56.7 vs. 50.1 years, p=0.007), had higher MELD score (26.8 vs. 20.8, p=0.019) and longer pre-transplant hospital LOS (20.9 vs. 6.4 days; p=0.003). Patients with delirium were also more likely to have alcohol as an etiology of the liver failure (p=.033). Delirious patients had a trend toward increased ventilator days (8.2 vs. 3.8 days, p=0.235) and significantly longer postoperative hospital (27.6 vs. 14.4 days p=0.001) and ICU LOS (9.5 vs. 4.5 days, p=0.001). Delirium was also associated with an increased frequency of urinary tract infections (22.2 vs. 6.5%, p=0.005) and pneumonias (27.8 vs. 4.6%, p=0.001).
8. Conclusions: Delirium is a common occurrence among liver transplant patients which is associated with increased complications and length of stays. Further prospective studies are needed to determine the specific risk factors in this complex population as well as to determine if delirium has an impact on long-term outcomes.
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