Evidence mapPaperPMID 41339857Full record

ArticleBMC oral health2025

Postoperative delirium in patients with free flap reconstruction after head and neck tumor surgery: influencing factors for severity and onset time, and a prediction model.

Zi-Xiu Liu, Zi-Li Yu, Gai-Li Chen, Ping Gong

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Article in BMC oral health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

4 authors.

Zi-Xiu LiuState Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
Zi-Li YuState Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
Gai-Li ChenDepartment of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China. gailichen@whu.edu.cn.
Ping GongState Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China. gongping@whu.edu.cn.

Funding

Project of Hubei Provincial Health Commission WJ2025M197Shanghai YRD Foundation for Innovation in Health Industry 2025-YRDFHI-011
6 · The paper itself

Abstract

backgroundPostoperative delirium (POD) is common after head and neck tumor surgery with free flaps, compromising immobilization and flap survival. However, robust tools for early POD severity prediction and systematic studies on onset-time heterogeneity are lacking.

methodsIn a retrospective cohort of 65 POD patients, demographic, perioperative, and postoperative data were analyzed. POD was subclassified by severity (CAM-ICU-7 score) and onset time (24-hour threshold). Descriptive, univariate and multivariate analyses identified independent influencing factors, and a prediction model for POD severity was developed and evaluated.

resultsSeverity: 39 severe and 26 non-severe, differing in mental state, clinical manifestations, onset time, duration, and olanzapine dose. Preoperative platelet-to-lymphocyte ratio (PLR) and intraoperative tropisetron dosage were independent influencing factors. The nomogram showed strong discrimination (AUC = 0.830), good calibration and clinical benefit. Onset time: 33 acute and 32 delayed, differing in POD duration and olanzapine dose. Preoperative diastolic blood pressure and PLR were independent influencing factors.

conclusionsPOD after head and neck tumor surgery shows marked heterogeneity in severity and onset. Neutrophils and platelets may respectively drive neuroinflammation occurrence and progression, synergizing with blood pressure to regulate POD subtyping. Identified factors enable early multidimensional warning. The prediction model performs well with optimal threshold 0.45-0.55.

Indexed as

DeliriumFree Tissue FlapsHead and Neck NeoplasmsPlastic Surgery ProceduresPostoperative ComplicationsAdultAgedFemaleHumansMaleMiddle AgedNomogramsOlanzapineRetrospective StudiesRisk FactorsSeverity of Illness IndexOlanzapineFree flapHead and neck tumorOnset timePostoperative deliriumPrediction modelSeverity

Identifiers

PMID41339857
PMCPMC12781720

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.