title: Alcohol-related predictors of delirium after major head and neck cancer surgery.
abstract: OBJECTIVE
  To identify specific alcohol-related predictors of postoperative delirium.
  
  
  METHODS
  Inception cohort, logistic regression with step-wise selection.
  
  
  METHODS
  Ohio State University Comprehensive Cancer Center, Columbus.
  
  
  METHODS
  A total of 774 patients undergoing major resection of head and neck squamous cell carcinoma.
  
  
  METHODS
  The correlation of 19 variables with postoperative delirium. One variable was an alcohol-related blood test: mean red blood cell volume (MCV). Eight variables were patient responses to alcohol-related questions.
  
  
  RESULTS
  Eighty-nine of 774 surgical procedures (11.5%) were complicated by delirium. Six variables were significantly associated with delirium: age older than 69 years (odds ratio [OR], 2.43; P < .01), preexisting cognitive impairment (OR, 3.83; P < .01), surgery duration greater than 6 hours (OR, 2.40; P < .01), MCV greater than 95.0 femtoliters (OR, 2.23; P < .01), ever being advised to cut back on alcohol (OR, 2.25; P = .01), and not abstaining from alcohol for at least 1 continuous week in the preceding year (OR, 2.16; P = .02). The number of variables stratified delirium risk (0 variables: 198 patients, 2.5% incidence of delirium; 1 variable: 278 patients, 6% incidence of delirium; 2 variables: 206 patients, 18% incidence of delirium; and >2 variables: 92 patients, 34% incidence of delirium).
  
  
  CONCLUSIONS
  Three clinical variables not related to alcohol drinking (age, preexisting cognitive impairment, and surgery duration), an alcohol-related laboratory test (MCV), and 2 alcohol-related questions ("At any time in your life, has anyone ever suggested that you should cut back on your drinking?" and "What is the greatest number of days in a row you have gone without an alcoholic drink in the past year?") may help in estimating a patient's risk for postoperative delirium.
authors.affiliation: Department of Radiology, College of Medicine and The Comprehensive Cancer Center-Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University, Columbus, OH 43201, USA.
authors.forename: Summit
authors.initials: S
authors.lastname: Shah
authors.forename: Harrison G
authors.initials: HG
authors.lastname: Weed
authors.forename: Xin
authors.initials: X
authors.lastname: He
authors.forename: Amit
authors.initials: A
authors.lastname: Agrawal
authors.forename: Enver
authors.initials: E
authors.lastname: Ozer
authors.forename: David E
authors.initials: DE
authors.lastname: Schuller
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects*; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology*; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003693:Delirium / Q000453:epidemiology*; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009820:Ohio / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D012307:Risk Factors