Post-Liver Transplant Delirium Is Associated With Increased Mortality and Prolonged Length of Stay

N. Oliver,¹ S. Anders,¹ A. Freeman,¹ K. Fine,¹ A. Cohen,^1,2 G. Loss,^1,2 H. Bohorquez.^1,2

¹Ochsner Health System, New Orleans, LA
²School of Medicine, The Queensland University, New Orleans, LA.

Meeting: 2015 American Transplant Congress

Abstract number: 108

Keywords: Liver, Mortality, Post-operative complications, Psychiatric comorbidity

Session Information

Session Name: Concurrent Session: Liver Retransplantation and Other Complications

Session Type: Concurrent Session

Date: Sunday, May 3, 2015

Session Time: 4:00pm-5:30pm

Presentation Time: 4:48pm-5:00pm

Location: Room 115-AB

Delirium after liver transplantation (LT) has been reported to increase ICU and hospital length of stay, but limited information is available regarding the incidence, potential risk factors and associated outcomes. With respect to liver transplantation, only ICU delirium has been studied.

Aim: To identify risk factors for and consequences of developing delirium at any time during the post-operative hospitalization.

Methods: This is a single-center, retrospective cohort study of adult patients who received a deceased LT from October 1, 2012 to March 31, 2014.

Results: Of 181 patients included in the study, 38 (20.9%) developed delirium after a mean of 6.9 days (IQR 4-8 days). Compared with control group, risk factors associated with developing delirium included history of depression (52.6% vs. 32.2%, p=0.02), previous hospital admission for encephalopathy (36.8% vs. 16.8%, p=0.01), hospitalization at the time of transplant offer (55.3% vs. 23.1%, p=0.0002), higher MELD score (25.01 vs. 19.25, p=0.0025), greater number of packed red blood cells infusions during LT (7.9 vs. 3.5, p=0.009), greater delta serum sodium within the 48 hours of LT (9.63 vs. 7.38, p=0.002), and need of post-LT renal replacement therapy (44.7% vs. 18.2%, p=0.001).

Concerning the consequences of delirium on the post-transplant resources, delirium was associated with a higher proportion of required diagnostic workup– including head CT (65.8% vs. 5.6%, p<0.001), head MRI (31.6% vs. 0.7%, p<0.001), and neurological and/or psychiatry consult service request (76.3% vs. 6.9%, p<0.001).

Patients with delirium had a longer duration of mechanical ventilation (1.99 vs. 1.28 days, p=0.0075), a longer mean ICU length of stay (4.58 days vs. 2.65 days, p=0.0082), a longer mean hospital length of stay (27.61 days vs. 11.17 days, p=0.0027), and higher 6-month mortality (13.2% vs. 1.4%, p=0.003).

Conclusion: Presence of delirium is common after LT and is associated with high morbidity and mortality within the first 6 months post-transplant. Efforts should be made to identify patients at risk for delirium to avoid prolonged length of stay and utilization of a greater number of resources.

To cite this abstract in AMA style:

Oliver N, Anders S, Freeman A, Fine K, Cohen A, Loss G, Bohorquez H. Post-Liver Transplant Delirium Is Associated With Increased Mortality and Prolonged Length of Stay [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/post-liver-transplant-delirium-is-associated-with-increased-mortality-and-prolonged-length-of-stay/. Accessed May 11, 2025.

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