Obstructive Sleep Apnea: A Risk Factor of Cardiac Valve Replacement Surgery

Ding, Ning; Ni, Buqing; Wang, Hong; Zhang, Shijiang; Zhang, Xilong

doi:10.5664/jcsm.6298

Cited by 3 publications

(3 citation statements)

References 12 publications

(10 reference statements)

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“…According to our initial hypothesis, we found an association between the higher risk of OSA and the postoperative increased rate of ICU readmission and wound infection. Prior studies demonstrated an increased risk of prolonged ICU and hospital LoS in patients undergoing major cardiac surgery [9,26,29]. Age, LVEF<50%, and CABG surgery are three independent risk factors for increased LoS in ICU.…”

Section: Discussionmentioning

confidence: 99%

Impact of Obstructive Sleep Apnea Diagnosed Using the STOP-Bang Questionnaire Scale on Postoperative Complications Following Major Cardiac Surgery: A Prospective Observational Cohort Study

Javaherforooshzadeh¹,

Amjadzadeh²,

Haybar³

et al. 2022

Cureus

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Obstructive sleep apnea (OSA) is a common and often undiagnosed condition in patients undergoing major surgeries, including cardiac surgery. This disorder is associated with peri-and postoperative problems. This study measured the association between OSA and peri-and postoperative complications in patients undergoing elective cardiac surgery. MethodsCandidates for elective cardiac surgery were evaluated for OSA by the STOP-Bang questionnaire before the surgery. We evaluated patients before and after the operation regarding the cardiac, respiratory, and neurologic complications. We divided the participants into high-risk (score of 5-8), intermediate-risk (score of 3-4), and low-risk groups (score of 0-2) based on the STOP-Bang questionnaire. ResultsOf the 306 patients who underwent cardiac surgery, 173 (56.5%) were in the high-risk group, 100 (32.7%) were in the intermediate-risk group, and 33 (10.8%) were in the low-risk group for OSA.Patients in the high-risk group were significantly older than the other two groups (p value=0.013), had higher BMI (p<0.001), and suffered more from relevant comorbid conditions, including diabetes mellitus, hypertension, and hyperlipidemia (all p-values significant at < 0.05). However, not significant, patients in the high-risk group suffered more from postoperative complications including cardiac, respiratory, and neurological complications. ConclusionOSA is common in patients undergoing cardiac surgery. Our findings indicate that these patients manifest a higher incidence of postoperative complications compared to those with a lower risk of OSA. Because of the limited use of polysomnography, a simple STOP-Bang questionnaire is beneficial to screen patients for the risk of OSA peri-operatively, and patients diagnosed with OSA can get extra care during and after the surgery.

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Section: Discussionmentioning

confidence: 99%

Impact of Obstructive Sleep Apnea Diagnosed Using the STOP-Bang Questionnaire Scale on Postoperative Complications Following Major Cardiac Surgery: A Prospective Observational Cohort Study

Javaherforooshzadeh¹,

Amjadzadeh²,

Haybar³

et al. 2022

Cureus

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“…In addition, as for the cardio-cerebrovascular complications, recent studies are based on patients diagnosed with different cardiac diseases undergoing various types of elective cardiac surgeries. [6][7][8] Data on CHD patients developing postoperative complications after CABG are sparse. As far as now, no meta-analyses have focused on documenting a direct correlation between CHD patients following elective CABG with OSA and higher risk of adverse cardiac and cerebral vascular events.…”

Section: Introductionmentioning

confidence: 99%

OSA-induced multi-organ dysfunction after elective coronary artery bypass surgery in coronary heart disease patients

Wang¹,

Wang²,

Yu³

et al. 2020

Preprint

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Background The aim of this study was to explore the underlying impact of obstructive sleep apnea (OSA) on postoperative parameters of multi-organ function, including cardiac and cerebral vascular, respiratory as well as renal postoperative complications, among coronary heart disease (CHD) patients following elective coronary artery bypass grafting (CABG). Methods Electronic literature databases, including PubMed, ISI Web of Science, Directory of Open Access Journals, and the Cochrane Library electronic databases, were searched manually and automatically for relevant English articles. All of the selected articles focused on a comparison of the incidence of primary and secondary outcomes in CHD patients undergoing elective CABG with and without OSA. Results A total of 13 articles met our inclusion criteria. The current study demonstrated OSA significantly increased the incidence of major adverse cardiac and cerebrovascular events (MACCEs) in CHD patients undergoing elective CABG compared with the controls (odds risk (OR), 1.97; 95% confidence interval (CI), 1.50 to 2.59, p <0.0001). In addition, OSA was associated with an increased risk of new revascularization in CHD patients undergoing elective CABG (OR, 9.47; 95% CI, 2.69 to 33.33, p <0.0001). Moreover, reintubation and tracheostomy in the OSA group was increased (OR, 3.43; 95% CI, 1.35 to 8.71; p =0.009) and 372% (OR, 4.72; 95% CI, 1.23 to 18.13; p=0.024), respectively, compared with the control group. Besides, we also confirmed OSA significantly increased the acute kidney injury (AKI) incidence by 124% (OR, 2.24; 95% CI, 1.07 to 4.72; P < 0.0001). Finally, our results demonstrated that OSA increased medical resource utilization including length of postoperative hospital stay and ICU stay. Conclusions OSA may contribute to postoperative multi-organ dysfunction among CHD patients undergoing elective CABG by increasing the incidence of MACCEs, especially new revascularization, as well as respiratory, and renal complications. Peri- and postoperative management of CHD patients with OSA may be optimized to minimize the rate of postoperative parameters of multi-organ dysfunction, further reducing the consumption of limited medical resources.

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“…Most of the evidence is focused on arrhythmia recurrence after cardiac surgery (4,5), the effects of OSA on respiratory as well as renal parameters still need to be investigated further. In addition, as for the cardio-cerebrovascular complications, recent studies are based on patients diagnosed with different cardiac diseases undergoing various types of elective cardiac surgeries (6)(7)(8). Data on CHD patients developing postoperative complications after CABG are sparse.…”

Section: Introductionmentioning

confidence: 99%

Obstructive sleep apnea-induced multi-organ dysfunction after elective coronary artery bypass surgery in coronary heart disease patients

Wang

et al. 2020

J Thorac Dis

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Background: The aim of this study was to explore the underlying impact of obstructive sleep apnea (OSA) on postoperative parameters of multi-organ function among coronary heart disease (CHD) patients following elective coronary artery bypass grafting (CABG). Methods: Electronic literature databases were searched manually and automatically for relevant English articles. All of the included articles focused on a comparison of the incidence of postoperative parameters of multi-organ function in CHD patients undergoing elective CABG with and without OSA. Studies were excluded if they met any one of the following criteria: (I) duplicate publication; (II) ongoing or unpublished studies; (III) only published as abstracts or conference proceedings; and (IV) less than 30 patients in the patient cohort. Results: A total of 13 articles met our inclusion criteria. The current study demonstrated OSA significantly increased the incidence of major adverse cardiac and cerebrovascular events (MACCEs) in CHD patients undergoing elective CABG compared with the controls [odds risk (OR), 1.97; 95% CI, 1.50 to 2.59, P<0.0001]. In addition, OSA was associated with an increased risk of new revascularization in CHD patients undergoing elective CABG (OR, 9.47; 95% CI, 2.69 to 33.33, P<0.0001). Moreover, reintubation and tracheostomy in the OSA group was increased 243% (OR, 3.43; 95% CI, 1.35 to 8.71; P=0.009) and 372% (OR, 4.72; 95% CI, 1.23 to 18.13; P=0.024), respectively, compared with the control group. Besides, we also confirmed OSA significantly increased the acute kidney injury (AKI) incidence by 124% (OR, 2.24; 95% CI, 1.07 to 4.72; P<0.0001). Conclusions: OSA may contribute to postoperative multi-organ dysfunction among CHD patients undergoing elective CABG by increasing the incidence of MACCEs, especially new revascularization, as well as respiratory, and renal complications.

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Obstructive Sleep Apnea: A Risk Factor of Cardiac Valve Replacement Surgery

Cited by 3 publications

References 12 publications

Impact of Obstructive Sleep Apnea Diagnosed Using the STOP-Bang Questionnaire Scale on Postoperative Complications Following Major Cardiac Surgery: A Prospective Observational Cohort Study

Impact of Obstructive Sleep Apnea Diagnosed Using the STOP-Bang Questionnaire Scale on Postoperative Complications Following Major Cardiac Surgery: A Prospective Observational Cohort Study

OSA-induced multi-organ dysfunction after elective coronary artery bypass surgery in coronary heart disease patients

Obstructive sleep apnea-induced multi-organ dysfunction after elective coronary artery bypass surgery in coronary heart disease patients

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