title: Postoperative delirium is associated with increased intensive care unit and hospital length of stays after liver transplantation.
abstract: 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.
  
  
  
  Retrospective case series in a tertiary care center examining all (n = 144) adult patients who underwent liver transplantation during a 6-y period.
  
  
  
  Delirium 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).
  
  
  
  Delirium 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.
authors.affiliation: Department of Surgery, Yale School of Medicine, New Haven, Connecticut. Electronic address: bishwajit.bhattacharya@yale.edu.
authors.forename: Bishwajit
authors.initials: B
authors.lastname: Bhattacharya
authors.affiliation: Department of Surgery, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Adrian
authors.initials: A
authors.lastname: Maung
authors.affiliation: Department of Surgery, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Barre
authors.affiliation: Department of Surgery, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Linda
authors.initials: L
authors.lastname: Maerz
authors.affiliation: Section of General Surgery, Trauma and Surgical Critical Care, Section of Transplant Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Manuel I
authors.initials: MI
authors.lastname: Rodriguez-Davalos
authors.affiliation: Section of General Surgery, Trauma and Surgical Critical Care, Section of Transplant Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Michael
authors.initials: M
authors.lastname: Schilsky
authors.affiliation: Section of General Surgery, Trauma and Surgical Critical Care, Section of Transplant Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut.
authors.forename: David C
authors.initials: DC
authors.lastname: Mulligan
authors.affiliation: Department of Surgery, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Davis
mesh_terms: D000328:Adult; D000368:Aged; D003693:Delirium / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D015995:Prevalence; D012189:Retrospective Studies
keywords: Complication; Delirium; Liver transplant