Analysis of risk factors for postoperative cognitive dysfunction in older patients undergoing surgery for oral malignancies

Background: This study aimed to analyse the incidence and risk factors associated with postoperative cognitive dysfunction (POCD) after malignant tumour resection and cervical lymphatic dissection in older adults undergoing oral and maxillofacial surgery. Methods: A total of 112 older patients (aged≥ 55 years) were selected for extended resection of descending oral malignancies at the Affiliated Stomatological Hospital of Chongqing Medical University from December 2020 to December 2021. Participants were cognitively evaluated using the neuropsychological test scale one day preceding and seven days after the surgery to determine whether they had developed POCD. Based on whether POCD occurred after seven days,patients were divided into the POCD and non-POCD groups. Logistic regression was applied to perioperative factors to analyse the risk factors for POCD onset. Results: Seven days following surgery for oral malignancy, there were 37 (33.1%) POCD morbidities. Multiple factor logistic regression analysis revealed that age (OR=1.269, 95%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%CI1.335-12.732, 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 risk of POCD in older patients who underwent surgery for oral malignancies. Conclusion: Venerable age, low knowledge reserve, hypertension, dyssomnia, prolonged anaesthesia, and intraoperative hypotension are independent risk factors for POCD in older patients with oral malignancies.