Format

Send to

Choose Destination
J Clin Anesth. 2014 Dec;26(8):591-600. doi: 10.1016/j.jclinane.2014.05.010. Epub 2014 Oct 16.

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

Author information

1
The Veterans Affairs Western New York Healthcare System, Western New York, Buffalo, NY 14215-1199, USA; Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY 14260, USA.
2
The Veterans Affairs Western New York Healthcare System, Western New York, Buffalo, NY 14215-1199, USA; Department of Anesthesiology, University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY 14260, USA.
3
The Veterans Affairs Western New York Healthcare System, Western New York, Buffalo, NY 14215-1199, USA; Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY 14260, USA; Department of Anesthesiology, University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY 14260, USA; Department of Social Preventive Medicine, University at Buffalo School of Medicine Biomedical Sciences, Buffalo, NY 14214, USA. Electronic address: solh@buffalo.edu.

Abstract

STUDY OBJECTIVE:

To determine whether a diagnosis of obstructive sleep apnea (OSA) imparts an increased risk of postoperative respiratory failure, cardiac events, and intensive care unit (ICU) transfer than patients with no OSA diagnosis.

DESIGN:

Systematic review and meta-analysis.

SETTING:

Academic Veterans Affairs Medical Center.

MEASUREMENTS:

PubMed, EMBASE, CINAHL, and ISI Web of Knowledge databases were searched through April 2013 for studies that examined the relationship between OSA and postoperative respiratory and cardiac complications among adults. Either fixed or random-effects models were used to calculate the pooled risk estimates. Sensitivity analysis was conducted to examine the robustness of pooled outcomes.

MAIN RESULTS:

Seventeen studies with a total of 7,162 patients were included. Overall, OSA was associated with significant increase in risk of respiratory failure [odds ratio (OR) 2.42; 95% confidence intervals (CI) 1.53 - 3.84; P = 0.0002] and cardiac events postoperatively (OR = 1.63; 95% CI 1.16 - 2.29; P = 0.005). Heterogeneity was low for these outcomes (I(2) = 5% and 0%, respectively). ICU transfer occurred also more frequently in patients with OSA (OR 2.46; 95% CI 1.29 - 4.68; P = 0.006). These results did not materially change in the sensitivity analyses according to various inclusion criteria.

CONCLUSIONS:

Surgical patients with OSA are at increased risk of postoperative respiratory failure, cardiac events, and ICU transfer.

KEYWORDS:

Postoperative complications; Respiratory failure; Sleep apnea

PMID:
25439403
DOI:
10.1016/j.jclinane.2014.05.010
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center