Analysis of Risk Factors for Postoperative Delirium in Patients with Esophageal Cancer

Abstract

Objective — To investigate the occurrence and risk factors of postoperative delirium in patients with esophageal cancer. Methods — A review of 203 patients undergoing elective surgery for esophageal cancer from April 2019 to December 2020, including 122 males and 81 females. The incidence of postoperative delirium were evaluated through the use of the CAM and divided into delirium group (Group P) and non-delirium group (Group N) according to whether postoperative delirium occurred. Possible confounders and clinically important factors were included in the univariate analysis, and all variables with P-values less than 0.05 in the univariate analysis were included in the multivariate models. Results — A total of 38 cases (18.7%) of postoperative delirium occurred in 203 patients. Group P was significantly older than Group N (P=0.000<0.01). The Patient Health Questionnaire 9 (PHQ-9) scores (P=0.01<0.05) and the FRAIL Scale scores of Group P were significantly higher than those of the N group (P=0.001<0.05). The educational level (P=0.001<0.01) and Mini-Mental State Examination (MMSE) scores (P=0.004<0.01) of Group P were significantly lower than those of Group N. The use rate of sevoflurane in Group P (P=0.011<0.05), the incidence of intraoperative hypotension (P=0.002<0.05), and the rate of Porphyromonas gingivalis infection (P=0.012<0.05) were higher than those in Group N. Multivariate logistic regression analysis showed that age (OR=1.295, 95%CI 1.125 ~ 1.490) and Porphyromonas gingivalis infection (OR=2.898, 95%CI 1.055 ~ 7.959) were independent risk factors for postoperative delirium in patients with esophageal cancer. Conclusion — age and Porphyromonas gingivalis infection may be the independent risk factors for postoperative delirium in patients with esophageal cancer.