Abstract
Postoperative delirium is a common complication after liver transplantation (LT). A high model for end-stage liver disease (MELD) score is an independent risk factor for postoperative delirium, but it is unclear which of the components of this score are risk indicators. The aim of this study was to analyze the incidence of postoperative delirium according to the preoperative serum bilirubin level, a component of the MELD score, in patients who underwent LT. The medical records of 325 patients who underwent LT from January 2010 to February 2019 at a single university hospital were retrospectively reviewed. The patients were divided into two groups: those who experienced postoperative delirium (Delirium group, n = 69) and those who did not (Control group, n = 256). Data on the patients’ demographic characteristics, perioperative management, and postoperative complications were collected. Mean preoperative bilirubin level was higher in the Delirium group than in the Control group (p < 0.0001). In the Delirium group, 54 (78.26%) patients had preoperative bilirubin levels above 3.5 mg/dL. In the multivariate analysis, preoperative bilirubin above 3.5 mg/dL was associated with postoperative delirium (p = 0.002). Therefore, preoperative hyperbilirubinemia is an independent risk factor for postoperative delirium.
Highlights
Postoperative delirium is a common complication after liver transplantation (LT), and the reported incidence of this condition varies from 9% to 32% [1,2,3]
A total of 325 patients were included in this study (Figure 1), 256 and 69 of whom were categorized into the Control group and the Delirium group, respectively
Postoperative delirium is a common complication after LT, and the reported incidence of this condition varies from 9% to 32% [1,2,3]
Summary
Postoperative delirium is a common complication after liver transplantation (LT), and the reported incidence of this condition varies from 9% to 32% [1,2,3]. Delirium after LT can be caused by prior hepatic encephalopathy (HE), metabolic impairments including serum sodium changes or hypomagnesemia, severe ascites, and immunosuppressants [2,4,5,6]. Postoperative delirium is associated with high post-transplant mortality and morbidity and increased medical expenses due to prolonged intensive. Med. 2020, 9, 1591 prolonged intensive care unit (ICU) and hospital stays [7,8]. Postoperative delirium results in cognitive impairment, which typically lasts several days to weeks, the course of this ccaorneduitnioitn(IiCsUu)suanaldlyhorespveitraslibsltea.ysTh[7e,r8e]f.orPeo, sittopiseriamtipveordtaenlitriutomidreesnutilftys ipnactioegnntsitivate himigphairrimskenotf, wphosicthoptyerpaitciavlelydlealsitrsiusmev.eral days to weeks, the course of this condition is usually reversible. TTehwerheeftohreer, tphreepopuerpraotsieveofseoruurmstbuidliyruwbains tleovienlviessatisgsaotceiawtehdetwhietrhptrheeoipnecriadteivneceseorfudmelibriiluirmubaifntelrevLeTl.is associated with the incidence of delirium after LT Ibnloaoddd–itbiorani,nthbeararnieersdthyessfiuan/scutirogner[y12m].iTghhet rienfdourec,etahne bpluoropdo–sberoafinoubrarsrtiuedrydywsafus ntoctiinovne[s1ti2g]a. tTehwerheeftohreer, tphreepopuerpraotsieveofseoruurmstbuidliyruwbains tleovienlviessatisgsaotceiawtehdetwhietrhptrheeoipnecriadteivneceseorfudmelibriiluirmubaifntelrevLeTl.is associated with the incidence of delirium after LT
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