{"title":"Risk Factors of Delirium Following Reconstructive Surgery for Head and Neck Tumors: A Retrospective Clinical Trial.","authors":"Lulan Li, Liupan Zhang, Xixuan Wu, Zhenhua Zeng","doi":"10.2147/TCRM.S480272","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Patients after head and neck tumor reconstruction surgery frequently require deep sedation and analgesia in the ICU. However, the risk factors for delirium associated with propofol-based sedation remain unclear.</p><p><strong>Objective: </strong>The study aimed to explore the risk factors of delirium of propofol singled or combined sedation.</p><p><strong>Methods: </strong>This retrospective study analyzed ICU patients who underwent head and neck tumor reconstruction surgery. The patients were divided into three groups: propofol (P), propofol + midazolam (PM), and propofol + dexmedetomidine (PD) groups. We utilized univariate and multivariate logistic regression to identify risk factors of delirium.</p><p><strong>Results: </strong>Delirium occurred in 4 (7.02%), 11 (28.21%), and 5 (20.83%) patients in the P, PM and PD groups, respectively. Elevated mean arterial pressure (MAP), increased aspartate aminotransferase (AST) levels, and the combined use of midazolam were determined to be significant risk factors for delirium in this patient cohort. The combined use of midazolam is the strongest predictor of delirium, which can increase the risk of delirium by 3.218 times (95% CI = 1.041-9.950, p = 0.042).</p><p><strong>Conclusion: </strong>Propofol combined with midazolam for sedation in patients after head and neck tumor reconstruction surgery may increase the risk of delirium.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"81-91"},"PeriodicalIF":2.8000,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774114/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Therapeutics and Clinical Risk Management","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/TCRM.S480272","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"Pharmacology, Toxicology and Pharmaceutics","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Patients after head and neck tumor reconstruction surgery frequently require deep sedation and analgesia in the ICU. However, the risk factors for delirium associated with propofol-based sedation remain unclear.
Objective: The study aimed to explore the risk factors of delirium of propofol singled or combined sedation.
Methods: This retrospective study analyzed ICU patients who underwent head and neck tumor reconstruction surgery. The patients were divided into three groups: propofol (P), propofol + midazolam (PM), and propofol + dexmedetomidine (PD) groups. We utilized univariate and multivariate logistic regression to identify risk factors of delirium.
Results: Delirium occurred in 4 (7.02%), 11 (28.21%), and 5 (20.83%) patients in the P, PM and PD groups, respectively. Elevated mean arterial pressure (MAP), increased aspartate aminotransferase (AST) levels, and the combined use of midazolam were determined to be significant risk factors for delirium in this patient cohort. The combined use of midazolam is the strongest predictor of delirium, which can increase the risk of delirium by 3.218 times (95% CI = 1.041-9.950, p = 0.042).
Conclusion: Propofol combined with midazolam for sedation in patients after head and neck tumor reconstruction surgery may increase the risk of delirium.
期刊介绍:
Therapeutics and Clinical Risk Management is an international, peer-reviewed journal of clinical therapeutics and risk management, focusing on concise rapid reporting of clinical studies in all therapeutic areas, outcomes, safety, and programs for the effective, safe, and sustained use of medicines, therapeutic and surgical interventions in all clinical areas.
The journal welcomes submissions covering original research, clinical and epidemiological studies, reviews, guidelines, expert opinion and commentary. The journal will consider case reports but only if they make a valuable and original contribution to the literature.
As of 18th March 2019, Therapeutics and Clinical Risk Management will no longer consider meta-analyses for publication.
The journal does not accept study protocols, animal-based or cell line-based studies.