Meta-analysis identifies risk factors for postoperative delirium in oral and maxillofacial surgery patients.
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Key Takeaway
Recognize alcohol, smoking, and age over 65 as associated with postoperative delirium in oral surgery patients.
This comprehensive meta-analysis evaluated risk factors associated with postoperative delirium in 2,398 patients undergoing oral and maxillofacial surgery. The scope focused on demographic and lifestyle exposures including age, sex, alcohol consumption, smoking, and insomnia. Authors synthesized evidence to determine the strength of association between these variables and delirium incidence.
Results indicated positive associations for several factors. Patients aged over 65 years had an odds ratio of 1.63 with a 95% CI (1.15, 2.31). Male sex was associated with an odds ratio of 1.90 (95% CI 1.17, 3.09). Alcohol consumption showed the strongest association with an odds ratio of 3.43 (95% CI 2.09, 5.66). Smoking and insomnia were also linked to higher risk, with odds ratios of 2.34 (95% CI 1.19, 4.59) and 2.27 (95% CI 1.24, 4.19), respectively.
Limitations noted by the authors include that available evidence is derived predominantly from major oral cancer and reconstructive surgery populations. All included studies were observational, meaning findings should be interpreted as associations rather than causal risk factors. Applicability to the broader spectrum of oral and maxillofacial surgery procedures remains uncertain. Clinicians should further consider these risk profiles when assessing patients, acknowledging the observational data constraints and potential for bias in the included literature.
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View Original Abstract ↓
BackgroundPostoperative delirium (POD) is a common and serious complication, particularly prevalent among patients undergoing oral and maxillofacial surgery (OMFS). Although studies have explored risk factors for POD, a systematic assessment for OMFS patients remains lacking. This study aimed to identify and synthesize factors associated with POD in patients undergoing OMFS. However, the currently available evidence appears to be derived mainly from major oncologic and reconstructive OMFS populations.MethodsThe literature search was conducted from the establishment of the database to December 10, 2025, covering PubMed, Embase, Cochrane Library, and Web of Science. All studies involving POD in patients undergoing OMFS were included in the analysis. The quality of included studies was assessed using the Newcastle-Ottawa Scale (NOS). Data analysis was performed using Stata 15 software, employing a random-effects model for meta-analysis of potential risk factors.ResultsA total of seven studies involving 2,398 patients were included. The meta-analysis showed that age >65 years [OR = 1.63, 95% CI (1.15, 2.31)], male sex [OR = 1.90, 95% CI (1.17, 3.09)], alcohol consumption [OR = 3.43, 95% CI (2.09, 5.66)], smoking [OR = 2.34, 95% CI (1.19, 4.59)], and insomnia [OR = 2.27, 95% CI (1.24, 4.19)] were associated with POD in patients undergoing OMFS.ConclusionThis study suggests that age >65 years, male sex, alcohol consumption, smoking, and insomnia may be associated with POD in patients undergoing OMFS. However, the available evidence is derived predominantly from major oral cancer and reconstructive surgery populations, and all included studies were observational. Therefore, these findings should be interpreted as associations rather than causal risk factors, and their applicability to the broader spectrum of OMFS procedures remains uncertain.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251267779
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