Analysis of the correlation between oral debility and the occurrence of postoperative delirium in elderly ICU patients

XU Wenjin; GU Yongmei; ZHANG Yan; ZHOU Linghua

doi:10.3969/j.issn.1674-3245.2025.06.019

Abstract：Objective To explore correlation between oral debility and postoperative delirium in elderly ICU patients.Methods 220 cases of ICU elderly postoperative patients admitted to Hai'an People's Hospital from January 2023 to December 2024 were selected.The ICU Ambiguity Assessment Scale for Consciousness(CAM-ICU)was used to assess whether delirium occurred or not in the patients at 7 days postoperatively.It was separated into a group of occurrences of postoperative delirium and a group of non-occurrences of postoperative delirium according to the occurrence of delirium.Their demographic and clinically relevant data were collected,and influencing factors of postoperative delirium in elderly patients in ICU were analyzed by univariate and multivariate analyses,and the predictive value was analyzed by using the subject's work characteristic curve(ROC);and the correlation between the patient's score on the Oral Failure Inventory(OFI-8)and the score on the Assessment of Ambiguity of Consciousness Scale for ICU(CAM-ICU-7)was analyzed by using the Pearson correlation analysis.Results Among 220 elderly ICU patients,83 patients(37.73%)had postoperative delirium and 137 patients(62.27%)did not have postoperative delirium.The results of univariate analysis showed that invasive mechanical ventilation,American Society of Anesthesiologists(ASA)grading,duration of surgery,postoperative Acute Physiology and Chronic Health Status Ⅱ(APACHE Ⅱ)scores,intraoperative hypothermia,benzodiazepine use,opioid use,oral debility and length of ICU stay were all statistically significant when comparing the two groups of patients(P<0.05).Logistic regression analysis showed that invasive mechanical ventilation,ASA classification,postoperative APACHE Ⅱ score,intraoperative hypothermia,benzodiazepine use,opioid use,oral debility and length of ICU stay were all influential factors for postoperative delirium in elderly patients in the ICU(P<0.05).The results of the ROC analysis showed that oral weakness and the combination of all the indexes predicted the occurrence of postoperative delirium in elderly patients,and the area under the curve(AUC)was 0.937(95%CI:0.904～0.969),which was higher than the AUC predicted by each indicator alone(P<0.05),with a sensitivity of 86.7%and a specificity of 89.1%.The results of the Pearson correlation analysis showed that OFI-8 scores of elderly patients in the ICU were positively correlated with CAM-ICU-7 scores(P<0.05).Conclusion There is a correlation between oral debility and the occurrence of postoperative delirium in elderly patients in ICU,which can provide a basis for early screening and intervention of postoperative delirium in elderly patients in ICU.