The influence of delirium on mortality and length of ICU stay and analysis of risk factors for delirium after liver transplantation

作者：Ying Ma, Cuiying Li, Weiting Peng, Qiquan Wan · 发表于：Frontiers in Neurology · 年份：2023 · DOI：10.3389/fneur.2023.1229990 · 被引用次数：18 · 研究领域：Intensive Care Unit Cognitive Disorders、Anesthesia and Neurotoxicity Research、Anesthesia and Sedative Agents

Objective To analyze the incidence, timing, risk factors and prognosis of delirium after liver transplantation (LT). Methods The clinical data of 321 patients undergoing LT in the Third Xiangya Hospital of Central South University from January 2018 to December 2022 were collected to investigate the incidence, onset, and risk factors for post-LT delirium and the impact of delirium on LT recipients’ prognosis by statistical analysis. Results The incidence of post-LT delirium was 19.3% (62/321), and the median interval between LT and onset of delirium was 20.1 h. Univariate analysis showed that pre-LT variables (Model for End Stage Liver Disease (MELD) score, hospital stay, hepatic encephalopathy, infection, white blood cell (WBC) count, lymphocyte count, abnormal potassium, lactulose use), intraoperative variables (red blood cell transfusion, remimazolam use, dexmedetomidine use) and post-LT variables (hypernatraemia, acute rejection, reoperation, basiliximab use, tacrolimus concentration) were associated with post-LT delirium. Multivariate logistic regression analysis revealed that MELD score at LT ≥22 [OR = 3.400, 95% CI:1.468–7.876, p = 0.004], pre-LT hepatic encephalopathy [OR = 3.224, 95% CI:1.664–6.244, p = 0.001], infection within 2 months prior to LT [OR = 2.238, 95% CI:1.151–4.351, p = 0.018], acute rejection [OR = 2.974, 95% CI:1.322–6.690, p = 0.008], and reoperation [OR = 11.919, 95% CI:2.938–48.350, p = 0.001] were independent risk factors for post-LT delirium. Pos...