Article Figures & Data
Figures
- Figure 1.
The incidence of post-kidney transplant (KT) delirium increased by recipient age and frailty status.
- Figure 2.
The time to discharge after kidney transplantation was longer for recipients with post-KT delirium. The median time to discharge differed between KT recipients with and without delirium (16 versus 8 days; P<0.001).
- Figure 3.
The cumulative incidence of mortality was greater among recipients with post-kidney transplant (KT) delirium. The log rank P value was <0.001.
Tables
- Table 1.
Characteristics of 893 kidney transplant recipients by post-kidney transplant delirium
Characteristic No Delirium Delirium N (%) 851 (95.3) 42 (4.7) Recipient characteristics Women 38.9 40.5 Black 40.4 57.1 Age, yr 52.2 (14.1) 60.4 (14.4) Years on dialysis 2.9 (3.6) 3.6 (6.1) BMI 28.4 (6.9) 28.3 (4.9) High school education or less 40.4 42.9 Time on dialysis, yr 2.9 (3.6) 3.6 (6.1) Cause of ESRD Diabetes 16.2 33.3 Hypertension 31.5 45.2 Glomerular disease 26.6 9.5 Cystic disease 10.6 0 Other 15.1 11.9 Frail 15.6 31.0 Cognitive impairment 9.1 19.1 Global cognitive function 92.1 (10.3) 88.2 (10.2) Poor HRQOL 8.8 11.9 Depressive symptoms 11.3 16.7 ADL disability 4.9 23.8 IADL disability 13.8 38.1 Comorbidities Charlson Comorbidity Index 1.5 (1.7) 2.6 (2.2) Myocardial infarction 5.2 14.3 Peripheral vascular disease 5.9 11.9 Cerebral vascular disease 2.1 0 Dementia 0 0 Chronic lung conditions 7.3 11.9 Rheumatologic disorders 20.6 28.6 Peptic ulcers 3.6 7.1 Diabetes 30.2 50.0 Moderate/severe liver disease 2.0 4.8 Metastatic cancer 0 0 Leukemia 0.2 0 Lymphoma 0.1 0 HIV 2.0 0 Transplant characteristics Deceased donor 61.2 81.0 Not on standard triple therapy 8.7 17.1 DGF 22.9 40.5 PRA>80% 14.7 4.8 Cold ischemia time, ha 26 (19–33) 24 (18–34) Characteristics are presented as percentages for binary variables and means (SD) for continuous variables except cold ischemia time, in which the medians (interquartile ranges) are presented. BMI, body mass index; HRQOL, health-related quality of life; ADL, activities of daily living; IADL, instrumental activities of daily living; DGF, delayed graft function; PRA, panel reactive antibody.
↵a For deceased donor recipients.
- Table 2.
Risk prediction models for post-kidney transplant delirium among kidney transplant recipients
Risk Factor Odds Ratio (95% CI) P Value Age 65 yr or older 2.65 (1.36 to 5.18) 0.004 Frail 2.05 (1.02 to 4.13) 0.04 Deceased donor KT 2.03 (0.91 to 4.52) 0.10 Two or more on the Charlson Comorbidity Index 1.93 (1.01 to 3.71) 0.05 Years on dialysis 1.06 (0.99 to 1.15) 0.10 All hazard ratios are from a single adjusted Cox proportional hazards model for delirium. The area under the receiver operating characteristic curve for the model is 0.73. 95% CI, 95% confidence interval; KT, kidney transplant.
- Table 3.
The association between post-kidney transplant (KT) delirium and length of stay, discharge location, death-censored graft loss, and mortality
Sequelae Unadjusted (95% CI) Adjusted (95% CI) Length of stay Days, RR 2.67 (2.27 to 3.14) 2.49 (2.13 to 2.91) 2 wk or Longer length of stay, OR 5.89 (3.09 to 11.21) 5.42 (2.76 to 10.66) Institutional discharge, OR 30.11 (11.42 to 79.36) 22.41 (7.85 to 63.98) Death-censored graft loss, HR 2.81 (1.21 to 6.54) 2.73 (1.14 to 6.53) Mortality, HR 4.72 (2.71 to 8.20) 3.12 (1.76 to 5.54) All models are adjusted for the recipient, transplant, and donor factors listed in Table 2. 95% CI, 95% confidence interval; RR, ratio of time; OR, odds ratio; HR, hazard ratio.
- Table 4.
Risk of death-censored graft loss and mortality for kidney transplant recipients with and without post-kidney transplant delirium
Sequelae Risk, % 1 yr 3 yr 5 yr Death-censored graft loss No delirium 2.3 5.5 9.2 Delirium 13.0 16.1 16.1 Mortality No delirium 2.2 7.3 10.4 Delirium 19.3 33.4 40.9 The risks (cumulative incidences) are expressed as percentages, and they are estimated using a Kaplan–Meier approach.
Supplemental Data
In this issue
