Delirium due to any cause is associated with higher resource utilization in patients undergoing liver transplantation: analysis of the National Inpatient Sample.

Objective: The only curative treatment for patients with end-stage liver disease (ESLD) is liver transplantation (LT). Patients with ESLD can develop delirium due to multiple etiologies. In this study, we aimed to assess the prevalence and impact of delirium on outcomes and resource utilization among hospitalized patients undergoing LT.

Methods: We used the National Inpatient Sample Database 2016-2020 to identify adult patients undergoing LT. Patients were stratified into two groups based on the presence of delirium. The outcomes studied were in-hospital mortality, perioperative adverse events, and resource utilization. Multivariate logistic and linear regression analysis was used to identify the relationship between delirium and outcomes.

Results: Of 34 405 included patients, 4930 (14.3%) patients had delirium. Patients with delirium had a higher need for renal replacement therapy (31.7% vs. 17.6%, P  < 0.001), vasopressor support (16.8% vs. 11.1%, P  < 0.001), and mechanical ventilation (34.1% vs. 15.3%, P  < 0.001). They also had higher total perioperative complications (77.3% vs. 60.4%, P  < 0.001), longer length of stay (34.8 vs. 17. 7, P  < 0.001), and total hospitalization charges ($927 200 vs. $565 486 P  < 0.001). After multivariable analysis, patients with delirium had higher odds of perioperative complications (adjusted odds ratio: 1.54, 95% confidence interval: 1.24-1.92, P  < 0.001) and resource utilization.

Conclusion: Our finding suggests the need for physicians to identify and reverse delirium as soon as possible.