title: Risk factors associated with postoperative delirium after surgery for oral cancer.
abstract: OBJECTIVE
  The purpose of this study was to retrospectively investigate the multivariate relationships among the various risk factors for postoperative delirium in patients undergoing oral cancer surgery.
  
  
  METHODS
  The medical records of all patients with oral cancer who underwent curative head and neck surgery between April 2011 and March 2013 at our institution were retrospectively reviewed. There was a total of 188 patients, including 110 males and 78 females.
  
  
  RESULTS
  We found that older age, extensive surgical procedure, longer operation, excessive hemorrhage, blood transfusion, longer postoperative management in the intensive care unit, longer postoperative hospital stay, lower albumin level in the preoperative blood test, and lower total protein, albumi, n and hemoglobin levels and a higher C-reactive protein (CRP) level in the postoperative blood tests were significant variables in the univariate analysis (p < 0.05). We also determined that an older age (odds ratio [OR] = 6.83), intraoperative lower hemoglobin levels (OR = 6.82), and excessive hemorrhage (OR = 3.62) during surgery were significant variables in the multivariate analysis.
  
  
  CONCLUSIONS
  Clinicians should pay special attention to preventing delirium during the postoperative management of older patients with these risk factors. Furthermore, increasing the hemoglobin levels during surgery may be able to prevent postoperative delirium.
authors.affiliation: Department of Oral and Maxillofacial Surgery (Chief: Prof. T. Komori), Kobe University Graduate School of Medicine, Japan. Electronic address: hasetaku@med.kobe-u.ac.jp.
authors.forename: Takumi
authors.initials: T
authors.lastname: Hasegawa
authors.affiliation: Department of Oral and Maxillofacial Surgery (Chief: Prof. T. Komori), Kobe University Graduate School of Medicine, Japan.
authors.forename: Izumi
authors.initials: I
authors.lastname: Saito
authors.affiliation: Department of Oral and Maxillofacial Surgery (Chief: Prof. T. Komori), Kobe University Graduate School of Medicine, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Takeda
authors.affiliation: Department of Oral and Maxillofacial Surgery (Chief: Prof. T. Komori), Kobe University Graduate School of Medicine, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Iwata
authors.affiliation: Department of Oral and Maxillofacial Surgery (Chief: Prof. T. Komori), Kobe University Graduate School of Medicine, Japan.
authors.forename: Natsuki
authors.initials: N
authors.lastname: Yonezawa
authors.affiliation: Department of Oral and Maxillofacial Surgery (Chief: Prof. T. Komori), Kobe University Graduate School of Medicine, Japan.
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Kakei
authors.affiliation: Department of Oral and Maxillofacial Surgery (Chief: Prof. T. Komori), Kobe University Graduate School of Medicine, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Sakakibara
authors.affiliation: Department of Oral and Maxillofacial Surgery (Chief: Prof. T. Komori), Kobe University Graduate School of Medicine, Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Akashi
authors.affiliation: Department of Oral and Maxillofacial Surgery (Chief: Prof. T. Komori), Kobe University Graduate School of Medicine, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Minamikawa
authors.affiliation: Department of Oral and Maxillofacial Surgery (Chief: Prof. T. Komori), Kobe University Graduate School of Medicine, Japan.
authors.forename: Takahide
authors.initials: T
authors.lastname: Komori
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001288:Attention / Q000502:physiology; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D001798:Blood Proteins / Q000032:analysis; D001803:Blood Transfusion / Q000706:statistics & numerical data; D002097:C-Reactive Protein / Q000032:analysis; D015331:Cohort Studies; D003243:Consciousness / Q000502:physiology; D003422:Critical Care / Q000706:statistics & numerical data; D003693:Delirium / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis; D013850:Thinking / Q000502:physiology; D055815:Young Adult
chemical_list: D001798:Blood Proteins; D006454:Hemoglobins; D012709:Serum Albumin; D002097:C-Reactive Protein
keywords: Delirium; Oral cancer; Postoperative; Risk factor; Surgery