Incidence and risk factors for postoperative delirium after major head and neck cancer surgery

• Published in: Journal of cranio-maxillo-facial surgery Vol. 44; no. 7; pp. 890 - 894
• Main Authors: Booka, Eisuke, Kamijo, Tomoyuki, Matsumoto, Teruaki, Takeuchi, Mari, Kitani, Takashi, Nagaoka, Masato, Imai, Atsushi, Iida, Yoshiyuki, Shimada, Ayako, Takebayashi, Katsushi, Niihara, Masahiro, Mori, Keita, Onitsuka, Tetsuro, Tsubosa, Yasuhiro, Takeuchi, Hiroya, Kitagawa, Yuko
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01.07.2016
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Dentistry; Emergence Delirium - epidemiology; Emergence Delirium - etiology; Female; Head and neck cancer; Head and Neck Neoplasms - surgery; Humans; Incidence; Male; Middle Aged; Older age; Operative Time; Postoperative delirium; Retrospective Studies; Risk Factors; Time Factors; Young Adult; Postoperative delirium; Head and neck cancer; Older age
• ISSN: 1010-5182; 1878-4119
• DOI: 10.1016/j.jcms.2016.04.032

Postoperative delirium is a common and serious complication after extensive surgery. This study aimed to investigate the incidence and risk factors for postoperative delirium after major head and neck cancer surgery. A retrospective analysis was performed for 293 patients who underwent major head and neck cancer surgery lasting >6 h at our institution between January 2012 and November 2015. All data were assessed by two psychiatrists. Univariate and multivariate analyses were performed. Postoperative delirium developed in 50 (17.1%) patients; most cases (84.0%) of postoperative delirium were observed between postoperative day (POD) 1 and POD 3. Multivariate analysis revealed that an age >70 years was the significant risk factor for postoperative delirium incidence after major head and neck cancer surgery; the multivariate hazard ratio was 3.935 (95% confidence interval 1.873–8.265, p < 0.001). Most cases of postoperative delirium after major head and neck cancer surgery were observed between POD 1 and POD 3, and a multivariate analysis revealed that an age >70 years was a significant risk factor for postoperative delirium incidence. Clinicians should pay particular attention to the possibility of delirium incidence during the first 3 days after surgery for patients aged >70 years.