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Delirium after lung transplantation: Association with recipient characteristics, hospital resource utilization, and mortality
Author(s) -
Sher Yelizaveta,
Mooney Joshua,
Dhillon Gundeep,
Lee Roy,
Maldonado José R.
Publication year - 2017
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12966
Subject(s) - delirium , medicine , mechanical ventilation , intensive care unit , logistic regression , proportional hazards model , lung transplantation , risk factor , organic mental disorders , intensive care medicine , transplantation , emergency medicine , pediatrics , anesthesia
Background Delirium is associated with increased morbidity and mortality. The factors associated with post‐lung transplant delirium and its impact on outcomes are under characterized. Methods 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. Results 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). Conclusions Delirium is common after lung transplant surgery and associated with increased hospital resources.