Sleep Apnea: Is Routine Preoperative Screening Necessary?

Nepomnayshy, Dmitry; Hesham, Walid; Erickson, Brandon J.; MacDonald, Julie; Iorio, Richard; Brams, David M.

doi:10.1007/s11695-012-0806-x

Cited by 38 publications

(18 citation statements)

References 21 publications

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“…Of the included risk prediction models, only DeMaria et al tested all their patients with polysomnography prior to surgery. However, the need for testing preoperatively is heavily debated by some authors [47]. Some significant predictors were absent in our validation cohort, like BMI >70 (LABS), a dependent or impaired functional status (LABS, Gupta et al and Maciejewski et al), age ≥65 years (Maciejewski et al), and ASA class 4/5 (Maciejewski et al).…”

Section: Resultsmentioning

confidence: 81%

Risk Stratification Models: How Well do They Predict Adverse Outcomes in a Large Dutch Bariatric Cohort?

et al. 2015

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The overall majority of the included risk models are unsuitable for risk prediction. Only one model with an emphasis on surgeon- and center-related factors instead of patient-related factors predicted adverse outcome correctly in our external validation cohort. These findings support the establishment of specialty centers and warn benchmark data institutions not to correct bariatric outcome data by any other patient-related factor than age.

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Section: Resultsmentioning

confidence: 81%

Risk Stratification Models: How Well do They Predict Adverse Outcomes in a Large Dutch Bariatric Cohort?

et al. 2015

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“…No observational evidence directly addressing the question was found. Meta-analysis of observational studies suggested that patients with obstructive sleep apnea or related disorders were more likely to sustain atrial fibrillation (OR 1.51, 95% CI 1.36 to 1.69) or hypoxemia (WMD − 3.8%, 95% CI − 5.4% to − 2.2%) [45][46][47][48][49][50][51][52][53][54][55][56][57][58][59]. The latter outcome might not be clinically important, whereas the summary certainty in the evidence was very low due to risk of bias (non-controlled confounders in cohort studies), imprecision, statistical and conceptual heterogeneity (differences in definition of sleep apnea and method of diagnosis) (Supplementary Table 6).…”

Section: Justificationmentioning

confidence: 99%

Clinical practice guidelines of the European Association for Endoscopic Surgery (EAES) on bariatric surgery: update 2020 endorsed by IFSO-EC, EASO and ESPCOP

et al. 2020

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Background Surgery for obesity and metabolic diseases has been evolved in the light of new scientific evidence, long-term outcomes and accumulated experience. EAES has sponsored an update of previous guidelines on bariatric surgery. Methods A multidisciplinary group of bariatric surgeons, obesity physicians, nutritional experts, psychologists, anesthetists and a patient representative comprised the guideline development panel. Development and reporting conformed to GRADE guidelines and AGREE II standards. Results Systematic review of databases, record selection, data extraction and synthesis, evidence appraisal and evidence-todecision frameworks were developed for 42 key questions in the domains Indication; Preoperative work-up; Perioperative management; Non-bypass, bypass and one-anastomosis procedures; Revisional surgery; Postoperative care; and Investigational procedures. A total of 36 recommendations and position statements were formed through a modified Delphi procedure. and Other Interventional Techniques Disclaimer This clinical practice guideline has been developed under the auspice of the European Association for Endoscopic Surgery (EAES). It is intended to be used primarily by health professionals (e.g. surgeons, anesthetists, physicians) and to assist in making informed clinical decisions on diagnostic measures and therapeutic management. It is also intended to inform individual practice of allied health professionals (e.g. surgical nurses, dietitians, physical rehabilitation therapists, psychologists); to inform strategic planning and resource management by healthcare authorities (e.g. regional and national authorities, healthcare institutions, hospital administration authorities); and to inform patients wishing to obtain an overview of the condition of interest and its management. The use of recommendations contained herein must be informed by supporting evidence accompanying each recommendation and by research evidence that might not have been published by the time of writing the present document. Users must thus base their actions informed by newly published evidence at any given point Electronic supplementary material The online version of this article (

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“…Adequate control of previously identified comorbidity like hypertension and diabetes mellitus and undiagnosed obesity related pathology such as obstructive sleep apnea (OSA) must be excluded. This is not uncommon as was demonstrated by Nepomnayshy et al in a study of 882 morbidly obese patients screened for sleep apnea prior to bariatric surgery, where they identified an additional 25 percent of patients with OSA [16]. Obese patients should be evaluated for predictors of both difficult mask ventilation and difficult intubation, as additional equipment and skilled personnel should be readily available if necessary.…”

Section: Anaesthetic Assessmentmentioning

confidence: 93%

Surgery for the obese

Amjad¹

2014

Sri Lanka j Surg

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This review focuses on the problem of obesity from an Asian perspective and the current evidence that supports the benefits of bariatric surgery over conventional treatment for sustained weight loss. The requirements for an effective bariatric surgical service are highlighted. Principles of peri-operative management and the currently practiced operative procedures are discussed briefly. Finally a short evaluation of the benefits and complication of the different procedures are presented.3

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Sleep Apnea: Is Routine Preoperative Screening Necessary?

Cited by 38 publications

References 21 publications

Risk Stratification Models: How Well do They Predict Adverse Outcomes in a Large Dutch Bariatric Cohort?

Risk Stratification Models: How Well do They Predict Adverse Outcomes in a Large Dutch Bariatric Cohort?

Clinical practice guidelines of the European Association for Endoscopic Surgery (EAES) on bariatric surgery: update 2020 endorsed by IFSO-EC, EASO and ESPCOP

Surgery for the obese

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