Prevalence of sleep apnoea in patients undergoing operation

Fidan, Hüseyin; Fidan, Fatma; Ünlü, Mehmet; Ela, Yüksel; Ibis, Arif; Tetik, Levent

doi:10.1007/s11325-006-0067-9

Cited by 47 publications

(67 citation statements)

References 23 publications

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“…Moreover, studies that reported a high prevalence of SDB in presurgical patients were subject to signifi cant selection bias because not all patients underwent polysomnography. 1,53,54 In the largest single academic center registry study of presurgical patients undergoing anesthesia, Ramachandran et al 25 reported an SDB prevalence of 7% in 43,576 adults. Therefore, we believe that the NIS database does not represent a signifi cant underreporting of clinically signifi cant cases of SDB.…”

Section: Discussionmentioning

confidence: 99%

Sleep-Disordered Breathing and Postoperative Outcomes After Elective Surgery

Mokhlesi¹,

Hovda²,

Vekhter³

et al. 2013

Chest

173

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Sleep-disordered breathing (SDB) is increasingly recognized as a possible risk factor for adverse perioperative outcomes. [1][2][3][4][5][6] Given the important implications of untreated SDB, the American Society of Anesthesiologists recommends screening patients prior to surgery for SDB and implementing treatment if SDB is present. 7 However, despite this growing awareness, there is a paucity of large-scale studies that examined the impact of SDB on postoperative outcomes. Moreover, given that systematic screening would impose a Background: Systematic screening and treatment of sleep-disordered breathing (SDB) or obstructive sleep apnea (OSA) in presurgical patients would impose a signifi cant cost burden; therefore, it is important to understand whether SDB is associated with worse postoperative outcomes. We sought to determine the impact of SDB on postoperative outcomes in patients undergoing four specifi c categories of elective surgery (orthopedic, prostate, abdominal, and cardiovascular). The primary outcomes were in-hospital death, total charges, and length of stay (LOS). Two secondary outcomes of interest were respiratory and cardiac complications. Methods: Data were obtained from the Nationwide Inpatient Sample database. Regression models were fi tted to assess the independent association between SDB and the outcomes of interest. 73; P , .001) but had no impact on mortality in the prostate surgery group. SDB was independently associated with a small, but statistically signifi cant increase in estimated mean LOS by 0.14 days ( P , .001) and estimated mean total charges by $860 ( P , .001) in the orthopedic surgery group but was not associated with increased LOS or total charges in the prostate surgery group. In the abdominal and cardiovascular surgery groups, SDB was associated with a signifi cant decrease in adjusted mean LOS of 1.1 days and 0.35 days, respectively ( P , .001 for both groups), and adjusted mean total charges of $3,814 and $4,592, respectively ( P , .001 for both groups). SDB was independently associated with a signifi cantly increased OR for emergent intubation and mechanical ventilation, noninvasive ventilation, and atrial fi brillation in all four surgical categories. Emergent intubation occurred signifi cantly earlier in the postoperative course in patients with SDB. In the subgroup of patients requiring emergent intubation, LOS, total charges, pneumonias, and in-hospital death were signifi cantly higher in those without SDB. Conclusions: In this large national study, despite the increased independent association of SDB with postoperative cardiopulmonary complications, the diagnosis of SDB was not independently associated with an increased rate of in-hospital death. SDB had a mixed impact on LOS and total charges by surgical category.

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Section: Discussionmentioning

confidence: 99%

Sleep-Disordered Breathing and Postoperative Outcomes After Elective Surgery

Mokhlesi¹,

Hovda²,

Vekhter³

et al. 2013

Chest

173

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“…Given a prevalence of 2-9.4% of OSA in our population [2,19] , only 8/8,824 (0.09%) patients had diagnosed or treated OSA during the screening period in this cohort, suggesting gross underrecognition of OSA. While the actual [5,6,20,21] and points to the magnitude of this problem. Thus, the first recognition of OSA during preoperative evaluation is not an infrequent event.…”

Section: Discussionmentioning

confidence: 99%

“…Results: 70/182 (38.5%) obtained a new diagnosis of OSA, including 11/182 (6%) with moderate to severe OSA (apneahypopnea index ≥ 15/h). On logistic regression analyses, the unrecognized OSA in preoperative adult surgical populations [4][5][6] . While the STOP-BANG questionnaire has been validated for preoperative screening of OSA, age, BMI, and neck circumference cutoffs in South Indians are likely quite different from the original cohort and the effect of this on the performance of the screening test is unknown.…”

Section: Introductionmentioning

confidence: 99%

Undiagnosed Obstructive Sleep Apnea and Postoperative Outcomes: A Prospective Observational Study

et al. 2017

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Background: The prevalence of undiagnosed obstructive sleep apnea (OSA) during preoperative evaluation and the best method to screen OSA and its association with postoperative complications remain unclear. Objectives: To determine the prevalence of undiagnosed OSA in preoperative Indian patients undergoing noncardiac surgery, to compare the diagnostic accuracy of the STOP-BANG questionnaire to a preoperative level III sleep study, and to assess the association of OSA with postoperative complications. Methods: A prospective cohort of 245 consecutive adults with ≥2 risk factors for OSA who underwent noncardiac surgery between July 2011 and February 2013 were studied. The STOP-BANG questionnaire was administered to all patients, and 182/245 (74.2%) patients underwent a preoperative level III sleep study. Patients were followed for postoperative complications in hospital and contacted at 30 days after surgery. Results: 70/182 (38.5%) obtained a new diagnosis of OSA, including 11/182 (6%) with moderate to severe OSA (apnea-hypopnea index ≥15/h). On logistic regression analyses, the presence of OSA was independently associated with postoperative oxygen desaturation (OR 5.96, 95% CI 2.35-15.1, p < 0.01), a postoperative complication within 7 days (OR 3.63, 95% CI 1.77-7.45, p < 0.01) and within 30 days (OR 3.5, 95% CI 1.74-7.1, p < 0.01). The STOP-BANG questionnaire did not identify 12/70 (17%) of the patients diagnosed with OSA and classified 28% of the cohort as OSA when the level III sleep study was negative. Conclusions: Unrecognized OSA is common in preoperative patients and is independently associated with postoperative complications. The STOP-BANG questionnaire had a lower performance in the diagnosis of OSA in a South Indian population than the level III sleep study.

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“…It has been determined that the incidence of OSA is higher in any patient group requiring surgery than in the general population (8). It is known that patients with OSA have higher perioperative risks than normal patients.…”

Section: Discussionmentioning

confidence: 99%

Turkish Anaesthesiologist’s Experiences of Anaesthetic Management of Patients with Obstructive Sleep Apnea (OSA)

Erbaş¹,

Kiraz²,

Şimşek³

et al. 2015

Turk J Anaesth Reanim

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Objective: Obstructive sleep apnea (OSA) is an important health problem that is increasing with the increase in the incidence of obesity. For patients with OSA, it is reported that preoperative OSA diagnosis is made in only 10%-20% of the patients. Therefore, it gains importance that these patients are diagnosed in the preoperative period. The aim of this study is to analyze with a survey the experiences of anaesthesia experts working in Turkey about the diagnosis of patients with OSA, anaesthetic methods and postoperative care. Methods:The study was completed with an online survey form distributed via email. Survey participants were sent an email, and those experts who wished to participate clicked on the link, answered the questions and returned the survey via email.Results: A total of 134 anaesthesia experts participated in this study. While 97% of the participating anaesthetists considered diagnosis of patients with OSA to be important, only 53% trusted themselves to recognize this patient group. Of the total number of participants. 43% did not know the STOP-BANG test used in the preoperative period to diagnose patients with OSA. The percentage who thought that patients with OSA would increase the incidence of difficult intubation was 84%. In the intraoperative period, the percentage who chose inhalation anaesthetics was 35%, whereas the rate of those who chose total intravenous anesthesia (TIVA) was 48%. Conclusion:This study indicates that the medical knowledge of Turkish anaesthetists on the topic of OSA requires updating. In addition, we believe a practical guide to standardize the diagnosis and preoperative/perioperative management of patients with OSA should be prepared for Turkish anaesthetists.

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Prevalence of sleep apnoea in patients undergoing operation

Cited by 47 publications

References 23 publications

Sleep-Disordered Breathing and Postoperative Outcomes After Elective Surgery

Sleep-Disordered Breathing and Postoperative Outcomes After Elective Surgery

Undiagnosed Obstructive Sleep Apnea and Postoperative Outcomes: A Prospective Observational Study

Turkish Anaesthesiologist’s Experiences of Anaesthetic Management of Patients with Obstructive Sleep Apnea (OSA)

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