Postoperative delirium in liver resection patients: Usefulness of the abdominal wall fat index

抄録

Postoperative delirium is one of the most common and important complications in patients who have undergone surgery. Although the precise mechanism of postoperative delirium is unclear, several risk factors have been reported. Here we investigated candidate risk factors for postoperative delirium after liver resection. This retrospective analysis included 112 consecutive patients who underwent an elective liver resection. Preoperative and intraoperative parameters were analyzed for their potential as risk factors of postoperative delirium. Thirty-one patients (27.7%) developed postoperative delirium. A multivariate analysis showed that advanced age (odds ratio [OR] = 1.189, 95% confidence interval [95%CI] = 1.081–1.309, p <0.001), the abdominal wall fat index (AFI) (OR 14.904, 95%CI 3.072–72.319, p <0.001), and non-laparoscopic surgery (OR 5.496, 95%CI 1.237–24.413, p=0.025) were independent risk factors for postoperative delirium. The AFI had a high OR for postoperative delirium. The area under the receiver-operating characteristic (ROC) curve was 0.806 (95%CI, 0.713–0.896) with a calculated optimal cut-off value of 1.0. The AFI is thus the most useful predictor for postoperative delirium after liver resection. Elderly patients with a higher AFI (>1.0) and open liver resection are associated with an increased risk of postoperative delirium.