World Journal of Surgery

, Volume 42, Issue 9, pp 2992–2999 | Cite as

Risk Factors of Postoperative Delirium in the Intensive Care Unit After Liver Transplantation

  • Hannah Lee
  • Seung-Young Oh
  • Je Hyuk Yu
  • Jeongsoo Kim
  • Sehee Yoon
  • Ho Geol Ryu
Original Scientific Report



Postoperative delirium after liver transplantation is relatively common, especially due to preexisting conditions such as hepatic encephalopathy. Most studies of delirium after liver transplantation were based on ICU practices using deep hypnosedation. Therefore, risk factors and consequences of postoperative delirium after liver transplantation were evaluated in the light sedation era.


A total of 253 liver transplantation patients were evaluated for postoperative delirium. Clinical outcomes including mortality were compared between patients who suffered delirium and those who did not. Risk factors for postoperative delirium were analyzed with subgroup analysis depending on MELD scores and type of liver transplantation.


Post-liver transplant delirium developed in 17% of the patients, 88% of which occurred within the first postoperative day. Alcoholic liver cirrhosis, class C Child–Pugh score, higher MELD scores, higher proportion of deceased donor liver transplantation, and reintubation were more frequent in patients who developed delirium, but there was no difference in mortality. Higher preoperative MELD group (15–24 vs. <15; OR 4.10, 95% Cl [1.67–10.09], P = 0.002, ≥25 vs. <15; OR 5.59, 95% CI [2.06–15.19], P < 0.01), higher APACHE II scores (OR 5.59, 95% CI [2.06–15.19], P < 0.01), and reintubation (OR 6.46, 95% CI [2.10–19.88], P < 0.01) were identified as significant risk factors for postoperative delirium.


Postoperative delirium after liver transplantation was associated with worse clinical outcomes. MELD scores greater than 15 were predictive of postoperative delirium in both living and deceased donor liver transplantation.


Compliance with ethical standards

Conflict of interest

The authors of this manuscript have no conflict of interest to disclose as described by the World Journal of Surgery.

Supplementary material

268_2018_4563_MOESM1_ESM.docx (14 kb)
Supplementary material 1 (DOCX 13 kb)


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Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • Hannah Lee
    • 1
  • Seung-Young Oh
    • 2
  • Je Hyuk Yu
    • 1
  • Jeongsoo Kim
    • 1
  • Sehee Yoon
    • 1
  • Ho Geol Ryu
    • 1
  1. 1.Department of Anesthesiology and Pain Medicine, Seoul National University HospitalSeoul National University College of MedicineSeoulKorea
  2. 2.Department of Surgery, Seoul National University Hospital Seoul National University College of MedicineSeoulKorea

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