Postoperative delirium is associated with increased long-term mortality following oral and maxillofacial reconstructive surgery.

Abstract

The aim of this study was to determine the impact of postoperative delirium (POD) on 2-year survival and identify perioperative risk factors contributing to POD in patients undergoing oral and maxillofacial reconstructive surgery. A retrospective observational study was conducted at Hokkaido University Hospital. The cohort included 65 patients who underwent oral and maxillofacial reconstructive surgery between January 2016 and May 2022. Patients were categorized into POD (n = 20) and non-POD (n = 45) groups. POD diagnosis was based on clinical criteria assessed by psychiatrists. Survival was analysed using Kaplan-Meier curves and a Cox proportional hazards model adjusted for age, American Society of Anesthesiologists (ASA) physical status, malignancy, and disease classification. POD occurred in 30.8% of patients. Two-year survival estimated by Kaplan-Meier analysis was significantly lower in POD group (60%) than in non-POD group (87%) (P = 0.009). POD was an independent risk factor for decreased survival (hazard ratio 3.40, 95% confidence interval 1.10-10.57; P = 0.034). No significant perioperative predictors of POD were identified. POD was associated with a substantial decrease in long-term survival following oral and maxillofacial reconstructive surgery. Early recognition and management of POD are critical to improving outcomes in this high-risk population.