Effect of hypertension and medication use regularity on postoperative delirium after maxillofacial tumors radical surgery

Abstract

The incidence of postoperative delirium (POD) after maxillofacial tumors radical surgery is relatively high. There are a number of evidences showing the relationship between hypertension and decreased cerebral blood flow, as well as the relationship between cerebral ischemia and postoperative cognitive impairment. However, the impact of hypertension in the process of POD and related mechanisms remain unclear. This study included 98 elderly patients who underwent maxillofacial tumors radical surgery in our hospital, from June 2020 to December 2020. We collected the general condition of patients and related research factors before surgery, and also collected related intraoperative factors. After that, we would follow up the patients for POD evaluation. The incidence of POD in the hypertension group was 41%, compared with 12% in the nonhypertension group (P < 0.05). The incidence of POD in the irregular medication group was 62%, compared with 26% in the regular medication group (P < 0.05). Both hypertension (OR = 2.45, 95% CI = 1.11-5.72) and irregular medication use (OR = 2.35, 95% CI = 0.87-5.69) were independent risk factors for POD after this type of surgery in elderly patients. Hypertension and medication use regularity are closely related to POD. This may be related to the delayed postoperative response caused by intraoperative cerebral ischemia.