Canadian Journal of Gastroenterology and Hepatology

Canadian Journal of Gastroenterology and Hepatology / 2013 / Article

Original Article | Open Access

Volume 27 |Article ID 289185 | https://doi.org/10.1155/2013/289185

Thomas Lescot, Constantine J Karvellas, Prosanto Chaudhury, Jean Tchervenkov, Steven Paraskevas, Jeffrey Barkun, Peter Metrakos, Peter Goldberg, Sheldon Magder, "Postoperative Delirium in the Intensive Care Unit Predicts Worse Outcomes in Liver Transplant Recipients", Canadian Journal of Gastroenterology and Hepatology, vol. 27, Article ID 289185, 6 pages, 2013. https://doi.org/10.1155/2013/289185

Postoperative Delirium in the Intensive Care Unit Predicts Worse Outcomes in Liver Transplant Recipients

Received20 Apr 2012
Accepted30 Jan 2013

Abstract

BACKGROUND: Delirium is common in intensive care unit patients and is associated with worse outcome.OBJECTIVE: To identify early risk factors for delirium in patients admitted to the intensive care unit following orthotopic liver transplantation (OLT).METHODS: An observational study of patients admitted to the intensive care unit from January 2000 to May 2010 for elective or semi-elective OLT was conducted. The primary end point was delirium in the intensive care unit. Pre- and post-transplantation and intraoperative factors potentially associated with this outcome were examined.RESULTS: Of the 281 patients included in the study, 28 (10.03%) developed delirium in the intensive care unit at a median of two days (interquartile range one to seven days) after OLT. According to multivariate analysis, independent risk factors for delirium were intraoperative transfusion of packed red blood cells (OR 1.15 [95% CI 1.01 to 1.18]), renal replacement therapy during the pretransplantation period (OR 13.12 [95% CI 2.82 to 72.12]) and Acute Physiologic and Health Evaluation (APACHE) II score (OR per unit increase 1.10 [95% CI 1.03 to 1.29]). Using Cox proportional hazards models adjusted for baseline covariates, delirium was associated with an almost twofold risk of remaining in hospital, a fourfold increased risk of dying in hospital and an almost threefold increased rate of death by one year.CONCLUSION: Intraoperative transfusion of packed red blood cells, pretransplantation renal replacement therapy and APACHE II score are predictors for the development of delirium in intensive care unit patients post-OLT and are associated with increased hospital lengths of stay and mortality.

Copyright © 2013 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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