Evaluation of factors associated with postoperative delirium in patients undergoing complex orthognathic surgery

Abstract

Purpose: Postoperative delirium (PD) is a common and severe complication, following extensive surgery and prolonged stays in intensive care units (ICU). The study aimed to estimate the frequency of and identify risk factors for PD in a unified orthognathic surgery patients. Methods: A retrospective cohort study composing of patients undergoing Maxillary and Mandibular orthognathic surgeries over 2 year. The predictor variables were identified as 146 general and periprocedural parameters. The primary outcome variable was PD (+ or -). Descriptive and bivariate statistics were performed to identify existing correlations between the predictive factors and PD and the P-value was set at 0.05. A logistic regression model (LRM) was created to adjust for possible confounding factors and reveal possible independent prognostic factors for the onset of PD. Results: 200 patients (36 with PD+, 164 without PD in patient history) undergoing Orthognathic Surgery [130 males, 70 females, mean age = 20 (range 18-40 years)] surgery were recruited. 15 variables that were statistically associated with PD were identified. In the LRM, after adjusting for age, diabetes status and preoperative TSH, Orthognathic surgery was associated with an risk for PD (Odds Ratio (OR) 6.3 (1.6-25.7, p=0.01).