Development of a risk prediction model for delirium following surgery for oral squamous cell cancer

Oral squamous cell carcinoma (OSCC) is a common malignancy that is commonly treated by surgical resection and - if necessary - with adjuvant radio(chemo)therapy. Depending on pre-existing patient related conditions and extent of surgery, postoperative intensive care may be indicated. Postoperative delirium (POD) is a frequent and serious complication in the intensive care unit (ICU), characterized by confusion and cognitive disturbances of the patient. This single-centre, retrospective study (2013–2023, University of Freiburg) analysed 299 OSCC patients admitted to ICU post-surgery to identify risk factors and develop a risk assessment tool for POD.A bias-reducing automated variable selection method identified ICU stay length, the use of percutaneous endoscopic gastrostomy (PEG) tubes, age, cancer stage, use of psychotropic and antihypertensive drugs to be associated with POD. Key predictors were used to create an online assessment tool, which predicted POD with about 85% accuracy. Notably, longer ICU stays increased POD risk, while the use of PEG tubes appeared to have a protective effect. Prospective studies are needed to validate the tool and to assess its clinical practicability.