For patients undergoing endoscopy procedures under conscious sedation, the presence of OSA does not clearly increase the risk of cardiorespiratory complications.
BACKGROUND: Patients with sleep apnea (OSA) have an increased risk of peri−operative complications. AIM: The purpose of this study is to assess whether OSA increases the risk of cardio−respiratory complications in patients undergoing endoscopic procedures. METHODS: A retrospective study was performed. We identified all patients who had undergone both an endoscopic procedure under conscious sedation and a sleep study from January 2002 to May 2008. Patients were divided into four groups; OSA negative (apnea hypopnea index (AHI) < 10/hr), OSA positive; mild: AHI 10−15/hr, moderate: AHI 15.1−30/hr and severe: AHI > 30/hr. Minor and major complications were identified. The minor ones were hypertension, hypotension, bradycardia, tachycardia, oxygen desaturation (<90%), bradypnea. Major complications included chest pain, respiratory distress, cardio− respiratory arrest or any minor complication that required intervention. RESULTS: 645 patients underwent 880 procedures: colonoscopies 64%, upper endoscopies 25%, and combined procedures 11%. The mean age was 60.5 years, mean body mass index 33.7, 93% were males. Sleep study results: 294 negative, 586 positive; 119 mild, 168 moderate and 299 severe. 24 % of patients had minor complications, while 7% had major complications. There was no significant difference between the patients with and without OSA in the rate of minor complications. (odds ratio 1.31, 95% confidence interval 0.84−1.54) or major complications (odds ratio 1.62, 95% confidence interval 0.78−2.25). The odds ratio was also not significantly increased when patients with severe or moderate to severe OSA were analyzed separately or when the normal range was restricted to < 5/hr. CONCLUSION: For patients undergoing endoscopy procedures under conscious sedation, the presence of OSA does not clearly increase the risk of cardio−respiratory complications. This abstract is funded by: None.
Am J Respir Crit Care Med
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