Nitta Yukie, Sanuki Takuro, Sugino Shigekazu, Sugimoto Masahiro, Kido Kanta
Department of Dental Anesthesiology, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.
Department of Dental Anesthesiology, Kanagawa Dental University, Yokosuka, Japan.
J Stomatol Oral Maxillofac Surg. 2025 Feb;126(1):102026. doi: 10.1016/j.jormas.2024.102026. Epub 2024 Aug 30.
Postoperative delirium (POD) is a severe complication associated with various adverse outcomes, especially in older patients. Although the incidence and risk factors for POD have been explored in general surgery, they have not been fully elucidated. Early identification of high-risk patients and active preoperative intervention are considered essential for the prevention of POD. Recently, psychiatric consultation intervention have been shown to prevent delirium. This study investigated the effect of preoperative psychiatric interventions on preventing POD in our specific surgical context.
This retrospective, single-center observational study included 86 patients who underwent major oral and maxillofacial surgery with free flap reconstruction between 2016 and 2023. The effect of psychiatric intervention were compared between patients with and without delirium.
Preoperative psychiatric intervention did not reduce the incidence of POD. The incidence of POD was 29.1 %. Univariate analyses showed no significant associations between POD and any clinical variables.
There was no difference in the incidence of POD between patients who received preoperative psychiatric intervention and those who did not, and further investigation is needed to determine the efficacy of preoperative psychiatric intervention in the prevention of POD.
术后谵妄(POD)是一种与多种不良后果相关的严重并发症,在老年患者中尤为常见。尽管普通外科领域已对POD的发病率和危险因素进行了探索,但尚未完全阐明。早期识别高危患者并进行积极的术前干预被认为是预防POD的关键。最近,精神科会诊干预已被证明可预防谵妄。本研究在我们特定的手术背景下,调查了术前精神科干预对预防POD的效果。
这项回顾性单中心观察性研究纳入了2016年至2023年间接受游离皮瓣重建的大型口腔颌面外科手术的86例患者。比较了发生谵妄和未发生谵妄患者的精神科干预效果。
术前精神科干预并未降低POD的发生率。POD的发生率为29.1%。单因素分析显示POD与任何临床变量之间均无显著关联。
接受术前精神科干预的患者与未接受干预的患者在POD发生率上没有差异,需要进一步研究以确定术前精神科干预在预防POD方面的疗效。