Postoperative complications in patients with obstructive sleep apnea: a meta-analysis

Hai, Faizi; Porhomayon, Jahan; Vermont, Leah N.; Frydrych, Lynne M.; Jaoude, Philippe; El-Solh, Ali

doi:10.1016/j.jclinane.2014.05.010

Cited by 118 publications

(64 citation statements)

References 41 publications

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“…This is particularly relevant for clinical practice guidelines, where over half the recommendations may be the consensus opinion of the panel [1,2]. In the workplace, we are also continually re-aligned by group edicts that descend from a myriad of department, hospital and college committees; it seems that no decision may be made without first forming a committee [3].…”

Section: Editorialmentioning

confidence: 99%

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The importance of obstructive sleep apnoea management in peri-operative medicine

2016

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Section: Editorialmentioning

confidence: 99%

“…Obstructive sleep apnoea (OSA) is associated with increased adverse peri-operative outcomes [1][2][3][4][5][6][7][8]. Studies of several large populationbased databases, including millions of patients and two meta-analyses, have shown that patients with OSA have an increased risk of postoperative complications [1][2][3][4][5][6][7].…”

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confidence: 99%

The importance of obstructive sleep apnoea management in peri-operative medicine

2016

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“…There is evidence that patients with untreated OSA, compared to those without this diagnosis, undergoing general surgical procedures, have worse postoperative outcomes including increased risks of post-operative cardiac events, acute respiratory failure and ICU transfers reported in two meta-analyses 13,14 . Data in patients undergoing cardiac surgery are inconsistent with some results suggesting an association between OSA and postoperative complications and others not supporting this association 15,16 .…”

Section: Postoperative Outcomes In Patients With Osa Undergoing Cardimentioning

confidence: 99%

Obstructive sleep apnoea in patients undergoing cardiac surgery: Screening, postoperative outcomes and perioperative care

Mason¹

2018

J Cardiol and Cardiovasc Sciences

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Obstructive sleep apnoea (OSA) is common and high prevalence has been described amongst patients undergoing cardiac revascularisation surgery. An excess of postoperative complications has been reported in patients with untreated Obstructive Sleep Apnoea (OSA) following surgical procedures, including those undergoing cardiac surgery. This has led some clinicians towards pre-operative screening for OSA though the best screening methodology has not yet been established. Moreover, the effect of screening and of treatment for OSA on surgical outcomes remains unknown. Does current evidence justify screening and treating patients before they present for surgery? Is this leading to potential delay in surgery whilst awaiting sleep diagnostics and commencing the treatment? This review article will examine the available evidence base and endeavour to answer these questions and identify implications for future research. OSA and cardiovascular diseaseSleep Disordered Breathing is a term used to cover a range of breathing events encountered during sleep and includes obstructive sleep apnoea (OSA), central sleep apnoea, Cheyne-Stokes respiration and respiratory effort related arousals. OSA is the most common form of sleep disordered breathing. OSA is common 1 and the reported prevalence has increased in the last two decades 1 with the new data reported mainly in European population of adults 40-85 years old showing that at least mild OSA (apnoea-hypopnoea index ≥5) was present in 84% of men and 61% of women and at least moderate disease (apnoea-hypopnoea index ≥15) was present in 50% of men and 23 % of women 2 . OSA and cardiac disease share some common risk factors and in patients undergoing coronary artery bypass graft (CABG) procedures reported prevalence is high, ranging between 41 and 87% 3-5 .High proportions of patients may present for surgery without a previous diagnosis of OSA 6,7 and may be at risk of worse postoperative outcomes 8 . In patients with moderate to severe OSA syndrome Continuous Positive Airway Pressure (CPAP) is the conventional treatment with established clinical and cost effectiveness 9 but its effect on cardiovascular outcomes has not been confirmed. A recent, large, randomised controlled trial of adults with moderate to severe OSA and pre-existing cardiovascular disease showed that the use of CPAP had no significant effect on the prevention of recurrent serious cardiovascular events 10 . It is possible that patients with compliance exceeding 4h/night may

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“…A sufficient number of controlled trials have now been performed such that two meta-analyses and two systematic reviews have examined this topic in detail [77][78][79]80••]. The most comprehensive, and most recent, of these reviews analyzed 61 studies and included over 400,000 OSA patients (due to the inclusion of large database studies) [80••].…”

Section: Osa and Perioperative Complicationsmentioning

confidence: 99%

Perioperative Complications in Obstructive Sleep Apnea Patients

Auckley

2016

Curr Sleep Medicine Rep

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Obstructive sleep apnea (OSA) is growing in prevalence though it still remains significantly underdiagnosed. Preoperative screening for OSA is taking place in many institutions, with a substantial number of patients being identified as having a high probability for OSA just prior to undergoing surgery. Emerging data increasingly demonstrates that patients with a high probability of having OSA as well as those with a known diagnosis of OSA may be at increased risk for developing complications in the perioperative setting. Postoperative cardiac and pulmonary adverse events appear to occur more frequently in these patients though the impact OSA has on postoperative mortality is controversial. In addition, determining which patients are at greatest risk remains an area of uncertainty. This chapter will review the current state of the knowledge regarding OSA as a risk factor for perioperative complications.

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Postoperative complications in patients with obstructive sleep apnea: a meta-analysis

Cited by 118 publications

References 41 publications

The importance of obstructive sleep apnoea management in peri-operative medicine

The importance of obstructive sleep apnoea management in peri-operative medicine

Obstructive sleep apnoea in patients undergoing cardiac surgery: Screening, postoperative outcomes and perioperative care

Perioperative Complications in Obstructive Sleep Apnea Patients

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