Postoperative Delirium in Patients Undergoing Tumor Resection with Reconstructive Surgery for Oral Cancer

Overview

Journal Mol Clin Oncol

Specialty Oncology

Date 2021 Feb 19

PMID 33604050

Citations 5

Authors

Nozomu Takahashi

Akimitsu Hiraki

Kenta Kawahara

Masashi Nagata

Ryoji Yoshida

Yuichiro Matsuoka

Takuya Tanaka

Yuko Obayashi

Junki Sakata

Hikaru Nakashima

Hidetaka Arita

Masanori Shinohara

Hideki Nakayama

Affiliations

Soon will be listed here.

Abstract

Many attempts have been made to identify the risk factors for postoperative delirium, but this has proved difficult due to its complex morbidity. Furthermore, there is little information on postoperative delirium in patients undergoing tumor resection and reconstructive surgery for oral cancer. The aim of the current study was to investigate the incidence of and risk factors for postoperative delirium in patients undergoing resection and reconstructive surgery for oral cancer. The present study included 104 patients with pedicle or free flap reconstruction. Postoperative delirium developed in 22 (21.2%) of these patients. The mean time to onset of postoperative delirium was 2.5±1.0 days and the duration of delirium was 1.9±1.2 days. Univariate analysis demonstrated that the occurrence of postoperative delirium was significantly correlated with operating time (P=0.033), duration of anesthesia (P=0.039), amount of blood loss (P=0.027), method of reconstruction (P=0.008), type of flap used (P=0.009) and time until postoperative ambulation (P=0.0008). Low postoperative red blood cell count (P=0.004), hemoglobin (P=0.004) and hematocrit (P=0.004) were significantly associated with delirium, but preoperative blood test results were not. The multiple logistic regression analysis of these risk factors revealed that the only significant correlation that remained was between postoperative delirium and the time to ambulation after surgery (P=0.005). Since 2009, the Department of Oral and Maxillofacial Surgery, Kumamoto University Hospital has promoted ambulation after the first two postoperative days for patients with oral cancer undergoing tumor resection with reconstruction, and the occurrence of postoperative delirium has decreased from 29.2 to 14.0%. The results of the current study suggest that early postoperative ambulation in patients who undergo reconstructive surgery for oral cancer is effective for preventing postoperative delirium.

Citing Articles

Postoperative delirium in oral and maxillofacial surgery: a scoping review.

Alhammadi E, Kuhlmann J, Rana M, Frohnhofen H, Moellmann H Head Face Med. 2024; 20(1):39.

PMID: 39044223 PMC: 11265362. DOI: 10.1186/s13005-024-00439-9.

Incidence and risk factors for postoperative delirium after head and neck cancer surgery: an updated meta-analysis.

Dong B, Yu D, Jiang L, Liu M, Li J BMC Neurol. 2023; 23(1):371.

PMID: 37848819 PMC: 10580509. DOI: 10.1186/s12883-023-03418-w.

Influence of perioperative blood pressure regulation on postoperative delirium in patients undergoing head and neck free flap reconstruction.

Ooms M, Schooss R, Winnand P, Heitzer M, Holzle F, Bickenbach J Eur J Med Res. 2023; 28(1):365.

PMID: 37736691 PMC: 10514994. DOI: 10.1186/s40001-023-01367-1.

Postoperative Delirium in Patients with Oral Cancer: Is Intraoperative Fluid Administration a Neglected Risk Factor?.

Obermeier K, Kraus M, Smolka W, Henkel J, Saller T, Otto S Cancers (Basel). 2022; 14(13).

PMID: 35804948 PMC: 9265071. DOI: 10.3390/cancers14133176.

Early Ambulation to Prevent Delirium After Long-Time Head and Neck Cancer Surgery.

Kim J, Lee Y, Kim Y, Cho K, Jung Y, Choi S Front Surg. 2022; 9:880092.

PMID: 35465424 PMC: 9022115. DOI: 10.3389/fsurg.2022.880092.

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