口腔颌面部恶性肿瘤患者术后发生谵妄的影响因素分析

Analysis of influencing factors of postoperative delirium in patients with oral and maxillofacial malignancy

目的目的探讨口腔颌面部恶性肿瘤(OMM)患者术后发生谵妄的影响因素。方法方法根据术后是否发生谵妄将106例OMM患者分为谵妄组(n=24)和对照组(n=82)。收集并比较两组患者的临床资料,采用二元Logis-tic回归模型分析OMM患者术后发生谵妄的影响因素。构建OMM患者术后谵妄预测模型列线图,绘制受试者工作特征(ROC)曲线并计算曲线下面积(AUC),验证模型的准确性。结果结果谵妄组中有酗酒史的患者比例明显高于对照组,谵妄组患者收缩压(SBP)明显低于对照组,差异均有统计学意义(P﹤0.01)。单因素和多因素Lo-gistic回归分析结果显示,高SBP是OMM患者术后发生谵妄的独立保护因素(P﹤0.05),酗酒史是OMM患者术后发生谵妄的独立危险因素(P﹤0.05)。预测模型的AUC为0.723(95%CI:0.614~0.832)。结论结论高SBP是OMM患者术后发生谵妄的保护因素,酗酒史是OMM患者术后发生谵妄的危险因素。医务工作者应针对上述影响因素及早干预,从而降低术后谵妄的发生风险。

Objective To explore the influencing factors of postoperative delirium in patients with oral and maxillofa-cial malignancy(OMM).Method According to whether delirium occurred after operation,106 OMM patients were di-vided into delirium group(n=24)and control group(n=82).The clinical data of the two groups were collected and com-pared,and the influencing factors of postoperative delirium in OMM patients were analyzed by binary Logistic regression model.The postoperative delirium prediction model nomogram of OMM patients was constructed,the receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was calculated to verify the accuracy of the model.Result The proportion of patients with history of alcoholism in delirium group was significantly higher than that in control group,and the SBP in delirium group was significantly lower than that in control group,and the differences were statistically significant(P<0.01).Univariate and multivariate Logistic regression analysis showed that high SBP was an independent protective factor for postoperative delirium in OMM patients(P<0.05),and history of alcoholism was an independent risk factor for postoperative delirium in OMM patients(P<0.05).The AUC of the prediction model was 0.723(95%CI:0.614-0.832).Conclusion High SBP is a protective factor for postoperative delirium in OMM patients,and history of alcoholism is a risk factor for postoperative delirium in OMM patients.According to the above factors,medical workers should intervene early to reduce the risk of postoperative delirium.