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TL;DR
This retrospective study analyzed 433 patients who underwent microvascular head and neck reconstruction between 2011 and 2019.
European Journal of Medical Research · 8 authors, 3 centres
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This retrospective study analyzed 433 patients who underwent microvascular head and neck reconstruction between 2011 and 2019.
This retrospective study analyzed 433 patients who underwent microvascular head and neck reconstruction between 2011 and 2019. Among them, 55 patients who developed postoperative delirium (POD) were matched with 55 patients without POD based on tracheotomy, flap type, and flap location. Intraoperative and postoperative systolic and mean arterial pressure (MAP) values were compared between groups. Patients with POD demonstrated lower intraoperative and postoperative minimum MAP values than patients without POD (60.0 vs. 65.0 mmHg, p<0.001; and 56.0 vs. 62.0 mmHg, p<0.001, respectively). A lower intraoperative minimum MAP was identified as a predictor for POD (OR 1.246, 95% CI 1.057–1.472, p=0.009), with a predictive cut-off of ≤62.5 mmHg (AUC 0.822, 95% CI 0.744–0.900, p<0.001). Limitations include the retrospective design, limited documentation quality, lack of preoperative cognitive assessment, and absence of mental health professionals for POD diagnosis. Postoperative minimum MAP showed lower values in the POD group in univariable testing but only tended toward significance in multivariable analysis.