Anesth Pain Med.  2019 Jul;14(3):322-330. 10.17085/apm.2019.14.3.322.

The effect of early extubation on postoperative delirium in patients with liver transplantation: a propensity score matching analysis

Affiliations
  • 1Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea. yoonji07@gmail.com
  • 2Department of Anesthesiology and Pain Medicine, Anam Hospital, Korea University College of Medicine, Seoul, Korea.
  • 3Department of Anesthesiology and Pain Medicine, Ansan Hospital, Korea University College of Medicine, Ansan, Korea.

Abstract

BACKGROUND
Maintenance of tracheal intubation is associated with use of sedatives, stress due to mechanical ventilation, or respiratory complications. The aim of this study is to compare the incidence of delirium between early and late extubation groups after liver transplantation (LT).
METHODS
Medical records from 247 patients who received LT from January 2010 to July 2017 in a single university hospital were retrospectively reviewed. Patients were divided with 2 groups: Those who underwent early extubation after LT (E group, n = 52) and those who underwent extubation within few hours of intensive care unit (ICU) admission after surgery (C group, n = 195). The patients' demographic data, perioperative managements and postoperative complications were collected. Early extubation was defined as performing extubation in the operating room after LT. A propensity score matching analysis was performed to reduce the effects of selection bias.
RESULTS
Among them, 4/52 (7.69%) in E group and 30/195 (15.38%) in C group occurred postoperative delirium after LT, respectively (P = 0.180). After propensity score matching, there was no difference of the period of hospitalization in ICU (P = 0.961), time to discharge after surgery (P = 0.117) and incidence of delirium between groups (P = 1.000).
CONCLUSIONS
Although this study is a retrospective study and limited by the small number of subjects, early extubation does not affect the incidence of delirium after LT. Therefore, further prospective studies on this were needed.

Keyword

Airway extubation; Delirium; Liver transplantation; Postoperative complication

MeSH Terms

Airway Extubation
Delirium*
Hospitalization
Humans
Hypnotics and Sedatives
Incidence
Intensive Care Units
Intubation
Liver Transplantation*
Liver*
Medical Records
Operating Rooms
Postoperative Complications
Propensity Score*
Prospective Studies
Respiration, Artificial
Retrospective Studies
Selection Bias
Hypnotics and Sedatives
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