Correlation Analysis On Risk Factors Of Delirium After Free Flap Grafting In Oral And Maxillofacial Malignancies

Objective:Delirium is defined as acute transient organic brain syndrome,which does not refer to a particular disease,but a clinical syndrome,in which the patient shows signs of cognitive decline and attention deficit within a few days of the operation.So far,the pathogenesis of delirium is not clear,and there is no definite conclusion about its risk factors.The study aims to provide a theoretical basis for preventing and reducing the occurrence of postoperative delirium by studying the relationship between age,gender,hypoxemia,airway management,blood transfusion and postoperative delirium after free flap grafting in oral and maxillofacial malignancies.So as to give positive treatment in the presence of postoperative delirium,and then eventually achieve the purpose of reducing mortality and improving the effect of the operation.Methods:Retrospective analysis of 324 patients who underwent free flap grafting of oral and maxillofacial malignancies from March 2013 to August 2017 in the eastern courtyard area of Shandong Provincial Hospital was carried out.Patients were evaluated using CAM as the evaluation tool.The age,gender,postoperative hypoxemia,postoperative airway management and blood transfusion of patients who meet the inclusion criteria were summed up.Single factor analysis was carried out by X2 test and there will be significant differences.The independent variables were brought into the logistic regression model for multifactor analysis to p<0.05,and the difference was statistically significant.Results:1.Single factor analysis of age,gender,the occurrence of hypoxemia after surgery,postoperative hypoxemia,postoperative airway management(whether tracheotomy)and whether or not blood transfusion was carried out on by the card side.And the results showed age,gender,postoperative airway management(whether tracheotomy),whether hypoxemia and blood transfusion occurred after operation,the test results of P value<0.05,that is,the above factors have a direct relationship with the occurrence of postoperative delirium;2.Logistic regression analysis showed that gender,age and postoperative occurrence of hypoxemia,p value<0.05,can be considered as an independent risk factor for postoperative delirium.Conclusion:1.The incidence of delirium after the operation of head and neck malignant tumors is high,about 12.04%;2.Age,gender,postoperative airway management,postoperative hypoxemia and whether blood transfusion are risk factors for postoperative delirium;3.Age,gender and postoperative hypoxemia are independent risk factors for postoperative delirium.