Analysis of risk factors for delirium in elderly patients with head and neck cancer after free flap reconstruction surgery
10.3760/cma.j.cn112144-20240907-00339
- VernacularTitle:老年患者头颈癌游离皮瓣修复术后发生谵妄的危险因素分析
- Author:
Sixing CHEN
1
;
Fengying QIN
;
Xiumei YU
;
Yijie HUANG
;
Shaoning ZHOU
;
Weiping GU
;
Qiumiao CHEN
Author Information
1. 广西医科大学口腔医学院·附属口腔医院手术麻醉科，南宁 530021
- Publication Type:Journal Article
- Keywords:
Head and neck neoplasms;
Free flap reconstruction surgery;
Postoperative delirium;
Risk factors
- From:
Chinese Journal of Stomatology
2025;60(1):54-60
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the risk factors for delirium after free flap reconstruction surgery in elderly patients with head and neck cancer.Methods:This study retrospectively collected clinical data from 309 elderly patients with head and neck cancer who underwent radical resection and free flap reconstruction surgery in the Department of Operation & Anesthesiology, College & Hospital of Stomatology, Guangxi Medical University from January 2018 to December 2022. Among them, there were 197 males (63.8%) and 112 females (36.2%), with an average age of (66.8±5.5) years old. Based on the delirium diagnostic criteria outlined in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, patients were evaluated for postoperative delirium within one week after surgery. They were then divided into a delirium group ( n=75) and a non-delirium group ( n=234). Perioperative indicators potentially related to postoperative delirium, including age, gender, past medical history, tumor characteristics, hematological tests, perioperative sleep disturbances, surgical procedures, intraoperative fluid intake and output, anesthetic dosage, postoperative pain, etc, were collected from the relevant medical record system.Variables with P<0.05 were included in a multivariate Logistic regression model to screen for independent risk factors for delirium. Results:The incidence of delirium after free flap reconstruction surgery for head and neck cancer in elderly patients was 24.3% (75/309). Multivariate Logistic regression analysis showed that male gender ( OR=2.802, P=0.005), perioperative sleep disturbances ( OR=7.104, P<0.001), and moderate-to-severe postoperative pain ( OR=6.903, P<0.001) were risk factors for postoperative delirium. Conclusions:Male gender, perioperative sleep disturbances, and moderate-to-severe postoperative pain are independent risk factors for delirium in these patients.
