Analysis of Risk Factors for Postoperative Delirium After Liver Transplantation

Junguo Chen, Hao Wang, Zhijun He, Ting Li Department of Organ Transplantation, The Second Xiangya Hospital, Central South University, Changsha, People’s Republic of ChinaCorrespondence: Ting LiLiver Transplantation, The Second Xiangya Hospital, No. 139 Middle Renmin Road, Changsha 410011,...

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Autores principales:	Chen J, Wang H, He Z, Li T
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	liver transplantation postoperative delirium ammonia hepatic encephalopathy risk factors. Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/d86a70c46db0484b9cb2429b21dcdd48
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spelling	oai:doaj.org-article:d86a70c46db0484b9cb2429b21dcdd482021-12-02T09:34:43ZAnalysis of Risk Factors for Postoperative Delirium After Liver Transplantation1178-2021https://doaj.org/article/d86a70c46db0484b9cb2429b21dcdd482020-07-01T00:00:00Zhttps://www.dovepress.com/analysis-of-risk-factors-for-postoperative-delirium-after-liver-transp-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Junguo Chen, Hao Wang, Zhijun He, Ting Li Department of Organ Transplantation, The Second Xiangya Hospital, Central South University, Changsha, People’s Republic of ChinaCorrespondence: Ting LiLiver Transplantation, The Second Xiangya Hospital, No. 139 Middle Renmin Road, Changsha 410011, People’s Republic of ChinaTel +86 15084909000Email liting001@csu.edu.cnPurpose: The study aimed to analyze the incidence of postoperative delirium (POD) and associated risk factors after liver transplantation (LT).Patients and Methods: We identified and enrolled patients undergoing LT at the Second Xiangya Hospital, Central South University between August 2018 and May 2019. We abstracted their relevant clinical information and assigned the patients into a POD group and non-POD group to compare differences in clinical information. Risk factors of POD were analyzed using logistic regression.Results: A total of 159 LT patients were enrolled. Forty-two patients exhibited delirium (26.4%). Of the 42 with delirium, 33 (78.6%) had delirium within 3 days postoperatively and a median duration of 5 days (quartile 3– 7 days). The results of binary logistic regression are as follows: preoperative ammonia (≥ 46 vs < 46 μmol/L; OR 3.51, 95% CI [1.31– 9.46], P< 0.05), Model for End-Stage Liver Disease (MELD) score (≥ 15 vs.< 15; OR 3.33, 95% CI [1.27– 8.79], P< 0.05), presence of hepatic encephalopathy (OR 3.30, 95% CI [1.20– 9.07], P< 0.05), aspartate aminotransferase (AST) on day 1 postoperatively (OR 1.33, 95% CI [1.06 − 1.68], P< 0.05), anhepatic period (OR 1.04, 95% CI [1.02 − 1.06], P< 0.01). The POD group had a longer intubation time (2925.0 vs 1410.0 min, P< 0.01), ICU length of stay (6 vs 4 d, P< 0.01) and increased medical costs (43.96 vs 33.74 ten thousand yuan, P< 0.01).Conclusion: The incidence of POD in LT patients is a significant clinical feature. Ammonia ≥ 46 μmol/l, MELD score ≥ 15, hepatic encephalopathy, anhepatic period, and AST at 1 day postoperatively were independent risk factors for POD.Keywords: liver transplantation, postoperative delirium, ammonia, hepatic encephalopathy, risk factorsChen JWang HHe ZLi TDove Medical Pressarticleliver transplantationpostoperative deliriumammoniahepatic encephalopathyrisk factors.Neurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 16, Pp 1645-1652 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	liver transplantation postoperative delirium ammonia hepatic encephalopathy risk factors. Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	liver transplantation postoperative delirium ammonia hepatic encephalopathy risk factors. Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Chen J Wang H He Z Li T Analysis of Risk Factors for Postoperative Delirium After Liver Transplantation
description	Junguo Chen, Hao Wang, Zhijun He, Ting Li Department of Organ Transplantation, The Second Xiangya Hospital, Central South University, Changsha, People’s Republic of ChinaCorrespondence: Ting LiLiver Transplantation, The Second Xiangya Hospital, No. 139 Middle Renmin Road, Changsha 410011, People’s Republic of ChinaTel +86 15084909000Email liting001@csu.edu.cnPurpose: The study aimed to analyze the incidence of postoperative delirium (POD) and associated risk factors after liver transplantation (LT).Patients and Methods: We identified and enrolled patients undergoing LT at the Second Xiangya Hospital, Central South University between August 2018 and May 2019. We abstracted their relevant clinical information and assigned the patients into a POD group and non-POD group to compare differences in clinical information. Risk factors of POD were analyzed using logistic regression.Results: A total of 159 LT patients were enrolled. Forty-two patients exhibited delirium (26.4%). Of the 42 with delirium, 33 (78.6%) had delirium within 3 days postoperatively and a median duration of 5 days (quartile 3– 7 days). The results of binary logistic regression are as follows: preoperative ammonia (≥ 46 vs < 46 μmol/L; OR 3.51, 95% CI [1.31– 9.46], P< 0.05), Model for End-Stage Liver Disease (MELD) score (≥ 15 vs.< 15; OR 3.33, 95% CI [1.27– 8.79], P< 0.05), presence of hepatic encephalopathy (OR 3.30, 95% CI [1.20– 9.07], P< 0.05), aspartate aminotransferase (AST) on day 1 postoperatively (OR 1.33, 95% CI [1.06 − 1.68], P< 0.05), anhepatic period (OR 1.04, 95% CI [1.02 − 1.06], P< 0.01). The POD group had a longer intubation time (2925.0 vs 1410.0 min, P< 0.01), ICU length of stay (6 vs 4 d, P< 0.01) and increased medical costs (43.96 vs 33.74 ten thousand yuan, P< 0.01).Conclusion: The incidence of POD in LT patients is a significant clinical feature. Ammonia ≥ 46 μmol/l, MELD score ≥ 15, hepatic encephalopathy, anhepatic period, and AST at 1 day postoperatively were independent risk factors for POD.Keywords: liver transplantation, postoperative delirium, ammonia, hepatic encephalopathy, risk factors
format	article
author	Chen J Wang H He Z Li T
author_facet	Chen J Wang H He Z Li T
author_sort	Chen J
title	Analysis of Risk Factors for Postoperative Delirium After Liver Transplantation
title_short	Analysis of Risk Factors for Postoperative Delirium After Liver Transplantation
title_full	Analysis of Risk Factors for Postoperative Delirium After Liver Transplantation
title_fullStr	Analysis of Risk Factors for Postoperative Delirium After Liver Transplantation
title_full_unstemmed	Analysis of Risk Factors for Postoperative Delirium After Liver Transplantation
title_sort	analysis of risk factors for postoperative delirium after liver transplantation
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/d86a70c46db0484b9cb2429b21dcdd48
work_keys_str_mv	AT chenj analysisofriskfactorsforpostoperativedeliriumafterlivertransplantation AT wangh analysisofriskfactorsforpostoperativedeliriumafterlivertransplantation AT hez analysisofriskfactorsforpostoperativedeliriumafterlivertransplantation AT lit analysisofriskfactorsforpostoperativedeliriumafterlivertransplantation
_version_	1718398092583108608

Analysis of Risk Factors for Postoperative Delirium After Liver Transplantation

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