Delirium after lung transplantation: Association with recipient characteristics, hospital resource utilization, and mortality.
Delirium is associated with increased morbidity and mortality. The factors associated with post-lung transplant delirium and its impact on outcomes are under characterized.



The medical records of 163 consecutive adult lung transplant recipients were reviewed for delirium within 5 days (early-onset) and 30 hospital days (ever-onset) post-transplantation. A multivariable logistic regression model assessed factors associated with delirium. Multivariable negative binomial regression and Cox proportional hazards models assessed the association of delirium with ventilator duration, intensive care unit (ICU) length of stay (LOS), hospital LOS, and one-year mortality.



Thirty-six percent of patients developed early-onset, and 44% developed ever-onset delirium. Obesity (OR 6.35, 95% CI 1.61-24.98) and bolused benzodiazepines within the first postoperative day (OR 2.28, 95% CI 1.07-4.89) were associated with early-onset delirium. Early-onset delirium was associated with longer adjusted mechanical ventilation duration (P=.001), ICU LOS (P<.001), and hospital LOS (P=.005). Ever-onset delirium was associated with longer ICU (P<.001) and hospital LOS (P<.001). After adjusting for clinical variables, delirium was not significantly associated with one-year mortality (early-onset HR 1.65, 95% CI 0.67-4.03; ever-onset HR 1.70, 95% CI 0.63-4.55).



Delirium is common after lung transplant surgery and associated with increased hospital resources.
Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA.
Yelizaveta
0000-0001-8127-5580
Y
Sher
Department of Medicine, Stanford University, Stanford, CA, USA.
Joshua
J
Mooney
Department of Medicine, Stanford University, Stanford, CA, USA.
Gundeep
G
Dhillon
Department of Pharmacy, Stanford Health Care, Stanford, CA, USA.
Roy
R
Lee
Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA.
José R
JR
Maldonado
D003693:Delirium / Q000209:etiology* / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006295:Health Resources / Q000706:statistics & numerical data*; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D066027:Transplant Recipients
cognitive disorder; delirium; delirium outcomes; lung transplant; lung transplantation