The impact of preoperative psychiatric intervention for postoperative delirium after major oral and maxillofacial surgery with free flap reconstruction

IF 1.8 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Journal of Stomatology Oral and Maxillofacial Surgery Pub Date : 2025-02-01 DOI:10.1016/j.jormas.2024.102026
Yukie Nitta , Takuro Sanuki , Shigekazu Sugino , Masahiro Sugimoto , Kanta Kido
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Abstract

Background

Postoperative delirium (POD) is a severe complication associated with various adverse outcomes, especially in older patients. Although the incidence and risk factors for POD have been explored in general surgery, they have not been fully elucidated. Early identification of high-risk patients and active preoperative intervention are considered essential for the prevention of POD. Recently, psychiatric consultation intervention have been shown to prevent delirium. This study investigated the effect of preoperative psychiatric interventions on preventing POD in our specific surgical context.

Materials and Methods

This retrospective, single-center observational study included 86 patients who underwent major oral and maxillofacial surgery with free flap reconstruction between 2016 and 2023. The effect of psychiatric intervention were compared between patients with and without delirium.

Results

Preoperative psychiatric intervention did not reduce the incidence of POD. The incidence of POD was 29.1 %. Univariate analyses showed no significant associations between POD and any clinical variables.

Conclusion

There was no difference in the incidence of POD between patients who received preoperative psychiatric intervention and those who did not, and further investigation is needed to determine the efficacy of preoperative psychiatric intervention in the prevention of POD.
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采用游离皮瓣重建的大型口腔颌面外科手术后,术前精神干预对术后谵妄的影响。
背景:术后谵妄(POD)是一种严重的并发症,与各种不良后果相关,尤其是在老年患者中。虽然已经对普外科手术中 POD 的发生率和风险因素进行了探讨,但尚未完全阐明。早期识别高危患者并进行积极的术前干预被认为是预防 POD 的关键。最近,精神科咨询干预被证明可以预防谵妄。本研究调查了在我们特定的手术环境中,术前精神干预对预防 POD 的影响:这项回顾性、单中心观察性研究纳入了 2016 年至 2023 年间接受口腔颌面大手术并进行游离皮瓣重建的 86 例患者。比较了有谵妄和无谵妄患者的精神干预效果:术前精神干预并未降低 POD 的发生率。POD发生率为29.1%。单变量分析显示,POD与任何临床变量之间均无明显关联:结论:接受术前精神干预的患者与未接受术前精神干预的患者在 POD 发生率上没有差异,因此需要进一步调查以确定术前精神干预对预防 POD 的有效性。
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来源期刊
Journal of Stomatology Oral and Maxillofacial Surgery
Journal of Stomatology Oral and Maxillofacial Surgery Surgery, Dentistry, Oral Surgery and Medicine, Otorhinolaryngology and Facial Plastic Surgery
CiteScore
2.30
自引率
9.10%
发文量
0
审稿时长
23 days
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