Clinical PaperHead and Neck OncologyClinical observations of postoperative delirium after surgery for oral carcinoma
Section snippets
Subjects
The authors retrospectively analysed 132 cases of oral carcinoma. All patients underwent primary surgery under general anaesthesia between January 2001 and September 2006.
Patients were diagnosed with postoperative delirium when symptoms corresponded to one of the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) definition2: disturbance of consciousness (i.e. reduced clarity of awareness of the environment) with reduced ability to focus,
Incidence of postoperative delirium
A total of 132 patients who underwent primary surgery for oral carcinoma were studied. Patient profiles are summarised in Table 1 and no significant gender-related differences were observed. Postoperative delirium occurred in 24 (18%) of 132 patients.
Risk factors revealed by univariate analyses
Univariate analyses revealed that older age (Student's t-test; p = 0.0023), male gender (Fisher's exact test; p = 0.0237), more extensive surgical procedure (Fisher's exact test; p = 0.0072) and postoperative pain control with morphine (Fisher's exact
Discussion
The incidence of postoperative delirium was 18% in the present study; this is similar to previous reports describing an incidence of 17–26% in patients undergoing resections of malignant head and neck tumours7, 14, 16. The present study showed a significant gender-related difference in the incidence of postoperative delirium, whereas previous studies have shown only a trend in this direction. No reports have shown female gender to be a risk factor for postoperative delirium, so it is reasonable
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