Risk factors for postoperative cognitive dysfunction in elderly patients undergoing surgery for oral malignancies

Abstract

We aimed to analyze postoperative cognitive dysfunction (POCD) incidence and risk factors in elderly adults who underwent surgery for oral malignancies. A total of 112 elderly patients (aged ≥ 55 years) were selected for extended resection of descending oral malignancies at our institution from December 2020 to December 2021. Participants were cognitively evaluated using the neuropsychological test scale 1 day preoperatively and 7 days postoperatively to determine whether they had developed POCD. Based on whether POCD occurred 7 days postoperatively, patients were classified into the POCD and non-POCD groups. Logistic regression was applied to perioperative factors to analyze the risk factors for POCD onset. Seven days postoperatively, there were 37 (33.1%) POCD morbidities. Multiple factor logistic regression analysis revealed that venerable age (odds ratio [OR]=1.269, 95% confidence interval [CI] 1.056−1.525, P<0.05), low education levels (OR=0.792, 95%CI 0.644−0.974, P<0.05), hypertension (OR=4.153, 95%CI 1.335−12.732, P<0.05), dyssomnia (OR=1.272, 95%CI 1.001−1.617, P<0.05), prolonged anaesthesia (OR=1.009, 95%CI 1.001−1.018, P<0.05), and intraoperative hypotension (OR=5.512, 95%CI 1.240−24.506, P<0.05) increased the POCD risk in elderly patients who underwent surgery for oral malignancies. Venerable age, low knowledge reserve, hypertension, dyssomnia, prolonged anaesthesia, and intraoperative hypotension are independent risk factors for POCD in elderly patients with oral malignancies.