Risk factors for postoperative delirium in patients undergoing microvascular decompression

PLoS One. 2019 Apr 18;14(4):e0215374. doi: 10.1371/journal.pone.0215374. eCollection 2019.

Abstract

This study is to identify the risk factors for postoperative delirium (PODE) in patients undergoing microvascular decompression (MVD) for the treatment of primary cranial nerve disorders. We retrospectively reviewed the data of 912 patients (354 men, 558 women) with primary cranial nerve disorders (trigeminal neuralgia, 602 patients; hemifacial spasm, 296 patients; glossopharyngeal neuralgia, 14 patients) who underwent MVD in the Neurosurgery Department of Lanzhou University Second Hospital between July 2007 and June 2018. Potential risk factors for PODE were identified using univariate and multivariate stepwise logistic regression analysis.Of the 912 patients, 221 (24.2%) patients developed PODE. Patients with PODE were significantly older and significantly more likely to be male than patients without PODE. A history of hypertension, preoperative carbamazepine therapy, and postoperative sleep disturbance and tension pneumocephalus were independently associated with PODE. Variables such as body-mass index, smoking and drinking habits, cardiac disease, diabetes mellitus, cerebrovascular disease, mean operative time, affected vessel, mean blood loss, postoperative intensive care unit stay, postoperative fever (>38°C), and routine laboratory results were not associated with PODE in our patients.PODE is a common complication after MVD, and is associated with multiple risk factors, including old age, male sex, hypertension, preoperative carbamazepine use, postoperative sleep disturbance, and tension pneumocephalus.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Delirium* / epidemiology
  • Delirium* / etiology
  • Delirium* / physiopathology
  • Female
  • Hemifacial Spasm / physiopathology
  • Hemifacial Spasm / surgery
  • Humans
  • Male
  • Microvascular Decompression Surgery / adverse effects*
  • Middle Aged
  • Postoperative Complications* / epidemiology
  • Postoperative Complications* / physiopathology
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • Trigeminal Neuralgia / physiopathology
  • Trigeminal Neuralgia / surgery

Grants and funding

This study was supported by grant number: 81560416, to HZH, funded by National Natural Science Foundation Project of China, http://www.nsfc.gov.cn/; grant number: 145RJYA256, to HZH, funded by Natural Science Foundation Project of Gansu province, http://www.gsstc.gov.cn/; grant number: 17JR5RA241, to HZH, funded by Natural Science Foundation Project of Gansu province, http://www.gsstc.gov.cn/; grant number: CY2017-MS11, to HZH, funded by Cuiying Scientific and Technological Innovation Program of Lanzhou University Second Hospital, http://www.lzush.com.cn/; grant number: GSWSKY2018-39, to HZH, funded by Gansu health industry planning project under the grant, http://www.gsws.gov.cn/. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.