What specific risk factors for Postoperative Delirium exist for oral and maxillofacial surgery patients?

Postoperative delirium (POD) is a serious complication that can occur after surgery, including oral and maxillofacial surgery (OMFS). It involves sudden confusion, inattention, and changes in thinking. Knowing the specific risk factors for OMFS patients can help you and your doctor take steps to reduce your risk. A 2025 meta-analysis of OMFS patients identified several key risk factors ³.

What the research says

A meta-analysis of 7 studies involving 2,398 OMFS patients found that several factors significantly increase the risk of POD ³. Patients older than 65 years had about 1.6 times higher odds of developing delirium compared to younger patients ³. Men were nearly twice as likely as women to experience POD ³. Alcohol consumption was a strong risk factor, with over 3 times higher odds ³. Smoking doubled the risk, and insomnia also roughly doubled the odds ³. These findings are specific to OMFS populations, which often involve major oncologic and reconstructive surgeries ³. Other research in broader surgical populations confirms that older age, preexisting cognitive problems, and multiple medical conditions are common risk factors ⁸¹⁰. Malnutrition, as measured by a low Geriatric Nutritional Risk Index, is also linked to higher POD risk in general surgical patients ⁴. While not specific to OMFS, these factors may also apply.

What to ask your doctor

• Given my age and sex, what is my personal risk for postoperative delirium?
• If I drink alcohol or smoke, should I stop before surgery to lower my risk?
• I have trouble sleeping sometimes. Could that affect my recovery, and what can I do about it?
• Are there any preoperative tests, like a nutritional assessment, that might help predict my delirium risk?
• What steps will the surgical team take to prevent delirium during and after my procedure?