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• W2896642743 abstract "In the surgical setting, OSA is associated with an increased risk of postoperative complications. At present, risk stratification using OSA-associated parameters derived from polysomnography (PSG) or overnight oximetry to predict postoperative complications has not been established. The objective of this narrative review is to evaluate the literature to determine the association between parameters extracted from in-laboratory PSG, portable PSG, or overnight oximetry and postoperative adverse events. We obtained pertinent articles from Ovid MEDLINE, Ovid MEDLINE In-Process & Other Non-Indexed Citations, and Embase (2008 to December 2017). The search included studies with adult patients undergoing surgery who had OSA diagnosed with portable PSG, in-laboratory PSG, or overnight oximetry that reported on specific sleep parameters and at least one adverse outcome. The search was restricted to English-language articles. The search yielded 1,810 articles, of which 21 were included in the review. Preoperative apnea-hypopnea index (AHI) and measurements of nocturnal hypoxemia such as oxygen desaturation index (ODI), cumulative sleep time percentage with oxyhemoglobin saturation (Spo2) < 90% (CT90), minimum Spo2, mean Spo2, and longest apnea duration were associated with postoperative complications. OSA is associated with postoperative complications in the population undergoing surgery. Clinically and statistically significant associations between AHI and postoperative adverse events exists. Complications may be more likely to occur in the category of moderate to severe OSA (AHI ≥ 15). Other parameters from PSG or overnight oximetry such as ODI, CT90, mean and minimal Spo2, and longest apnea duration can be associated with postoperative complications and may provide additional value in risk stratification and minimization. In the surgical setting, OSA is associated with an increased risk of postoperative complications. At present, risk stratification using OSA-associated parameters derived from polysomnography (PSG) or overnight oximetry to predict postoperative complications has not been established. The objective of this narrative review is to evaluate the literature to determine the association between parameters extracted from in-laboratory PSG, portable PSG, or overnight oximetry and postoperative adverse events. We obtained pertinent articles from Ovid MEDLINE, Ovid MEDLINE In-Process & Other Non-Indexed Citations, and Embase (2008 to December 2017). The search included studies with adult patients undergoing surgery who had OSA diagnosed with portable PSG, in-laboratory PSG, or overnight oximetry that reported on specific sleep parameters and at least one adverse outcome. The search was restricted to English-language articles. The search yielded 1,810 articles, of which 21 were included in the review. Preoperative apnea-hypopnea index (AHI) and measurements of nocturnal hypoxemia such as oxygen desaturation index (ODI), cumulative sleep time percentage with oxyhemoglobin saturation (Spo2) < 90% (CT90), minimum Spo2, mean Spo2, and longest apnea duration were associated with postoperative complications. OSA is associated with postoperative complications in the population undergoing surgery. Clinically and statistically significant associations between AHI and postoperative adverse events exists. Complications may be more likely to occur in the category of moderate to severe OSA (AHI ≥ 15). Other parameters from PSG or overnight oximetry such as ODI, CT90, mean and minimal Spo2, and longest apnea duration can be associated with postoperative complications and may provide additional value in risk stratification and minimization. OSA is a common sleep-related breathing disorder characterized by recurring episodes of complete or partial upper airway obstruction during sleep. It is estimated that OSA affects up to 27% of women and 43% of men aged 50 to 70 years and 9% of women and 26% of men aged 30 to 49 years.1Peppard P.E. Young T. Barnet J.H. Palta M. Hagen E.W. Hla K.M. Increased prevalence of sleep-disordered breathing in adults.Am J Epidemiol. 2013; 177: 1006-1014Crossref PubMed Scopus (2723) Google Scholar, 2Heinzer R. Vat S. Marques-Vidal P. et al.Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study.Lancet Respir Med. 2015; 3: 310-318Abstract Full Text Full Text PDF PubMed Scopus (1433) Google Scholar In the surgical setting, OSA presents many challenges because it is associated with an increased risk of postoperative complications, including cardiac and pulmonary complications; oxygen desaturations; difficult intubation; and, in rare instances, death.3Opperer M. Cozowicz C. Bugada D. et al.Does obstructive sleep apnea influence perioperative outcome? A qualitative systematic review for the Society of Anesthesia and Sleep Medicine Task Force on Preoperative Preparation of Patients With Sleep-Disordered Breathing.Anesth Analg. 2016; 122: 1321-1334Crossref PubMed Scopus (159) Google Scholar The prevalence of OSA is estimated to be at least 25% among candidates for elective surgery and may be as high as 80% in high-risk populations such as patients undergoing bariatric surgery.4Memtsoudis S.G. Besculides M.C. Mazumdar M. A rude awakening: the perioperative sleep apnea epidemic.N Engl J Med. 2013; 368: 2352-2353Crossref PubMed Scopus (80) Google Scholar In the patient with OSA, the intermittent upper airway obstruction leads to reductions in tidal volume and subsequent intermittent arterial hypoxemia and hypercapnia. The compensatory response involves a profound ventilatory response, activation of the sympathetic nervous system, and cortical arousals that disrupt normal sleep architecture causing daytime sleepiness.5Stradling J.R. Barbour C. Glennon J. Langford B.A. Crosby J.H. Prevalence of sleepiness and its relation to autonomic evidence of arousals and increased inspiratory effort in a community based population of men and women.J Sleep Res. 2000; 9: 381-388Crossref PubMed Scopus (54) Google Scholar This response also results in peripheral vasoconstriction, depressed myocardial contractility, oxidative stress, inflammation, and endothelial dysfunction.6Bradley T.D. Floras J.S. Obstructive sleep apnoea and its cardiovascular consequences.Lancet. 2009; 373: 82-93Abstract Full Text Full Text PDF PubMed Scopus (1011) Google Scholar, 7Drager L.F. McEvoy R.D. Barbe F. Lorenzi-Filho G. Redline S. Initiative I. Sleep apnea and cardiovascular disease: lessons from recent trials and need for team science.Circulation. 2017; 136: 1840-1850Crossref PubMed Scopus (256) Google Scholar Therefore, OSA is associated with cardiovascular sequelae such as coronary artery disease, left ventricular hypertrophy, hypertension,8Peppard P.E. Young T. Palta M. Skatrud J. Prospective study of the association between sleep-disordered breathing and hypertension.N Engl J Med. 2000; 342: 1378-1384Crossref PubMed Scopus (3952) Google Scholar atrial fibrillation (AF),9Gami A.S. Pressman G. Caples S.M. et al.Association of atrial fibrillation and obstructive sleep apnea.Circulation. 2004; 110: 364-367Crossref PubMed Scopus (881) Google Scholar pulmonary hypertension,10Sajkov D. Cowie R.J. Thornton A.T. Espinoza H.A. McEvoy R.D. Pulmonary hypertension and hypoxemia in obstructive sleep apnea syndrome.Am J Respir Crit Care Med. 1994; 149: 416-422Crossref PubMed Scopus (211) Google Scholar and cerebrovascular accidents.11Redline S. Yenokyan G. Gottlieb D.J. et al.Obstructive sleep apnea-hypopnea and incident stroke: the sleep heart health study.Am J Respir Crit Care Med. 2010; 182: 269-277Crossref PubMed Scopus (919) Google Scholar In the surgical setting, the administration of opioids, sedatives, and IV fluids may augment patient predisposition to sleep apnea by exacerbating upper airway collapse, depressing the arousal response, and intensifying rostral fluid shifts leading to upper airway edema and reduced patency.12Subramani Y. Nagappa M. Wong J. Patra J. Chung F. Death or near-death in patients with obstructive sleep apnoea: a compendium of case reports of critical complications.Br J Anaesth. 2017; 119: 885-899Abstract Full Text Full Text PDF PubMed Scopus (47) Google Scholar This difficulty is highlighted by the increase in both the severity of sleep apnea and arterial hypoxemia in those with known OSA13Chung F. Liao P. Elsaid H. Shapiro C.M. Kang W. Factors associated with postoperative exacerbation of sleep-disordered breathing.Anesthesiology. 2014; 120: 299-311Crossref PubMed Scopus (119) Google Scholar and the emergence of de novo OSA in approximately 26% of patients undergoing surgery.14Chung F. Liao P. Yang Y. et al.Postoperative sleep-disordered breathing in patients without preoperative sleep apnea.Anesth Analg. 2015; 120: 1214-1224Crossref PubMed Scopus (32) Google Scholar Furthermore, these nocturnal respiratory events and episodic hypoxemia can be associated with significant postoperative sequelae, including cardiac ischemia and arrhythmias.15Gogenur I. Rosenberg-Adamsen S. Lie C. Carstensen M. Rasmussen V. Rosenberg J. Relationship between nocturnal hypoxaemia, tachycardia and myocardial ischaemia after major abdominal surgery.Br J Anaesth. 2004; 93: 333-338Abstract Full Text Full Text PDF PubMed Scopus (30) Google Scholar, 16Gill N.P. Wright B. Reilly C.S. Relationship between hypoxaemic and cardiac ischaemic events in the perioperative period.Br J Anaesth. 1992; 68: 471-473Abstract Full Text PDF PubMed Scopus (115) Google Scholar The severity and duration of hypoxemia are also important because they have been correlated with the likelihood of myocardial ischemia.16Gill N.P. Wright B. Reilly C.S. Relationship between hypoxaemic and cardiac ischaemic events in the perioperative period.Br J Anaesth. 1992; 68: 471-473Abstract Full Text PDF PubMed Scopus (115) Google Scholar Gami et al17Gami A.S. Howard D.E. Olson E.J. Somers V.K. Day-night pattern of sudden death in obstructive sleep apnea.N Engl J Med. 2005; 352: 1206-1214Crossref PubMed Scopus (826) Google Scholar observed that the incidence of sudden cardiac death was highest during normal hours of sleep (midnight to 6 AM) in patients with OSA. In contrast, patients without OSA experienced these events most frequently in the morning after 6 AM, which suggests a potential link between nocturnal sleep-disordered breathing and cardiovascular dysfunction.17Gami A.S. Howard D.E. Olson E.J. Somers V.K. Day-night pattern of sudden death in obstructive sleep apnea.N Engl J Med. 2005; 352: 1206-1214Crossref PubMed Scopus (826) Google Scholar In the postoperative period, 80% of death or near-death events in patients with OSA are observed within the first 24 h after surgery, with the majority of these events occurring on the hospital ward, a vulnerable situation in which patients are not meticulously monitored.12Subramani Y. Nagappa M. Wong J. Patra J. Chung F. Death or near-death in patients with obstructive sleep apnoea: a compendium of case reports of critical complications.Br J Anaesth. 2017; 119: 885-899Abstract Full Text Full Text PDF PubMed Scopus (47) Google Scholar Therefore, it is of utmost importance to identify patients with OSA who are at risk of postoperative complications.18Chung F. Memtsoudis S.G. Ramachandran S.K. et al.Society of Anesthesia and Sleep Medicine guidelines on preoperative screening and assessment of adult patients with obstructive sleep apnea.Anesth Analg. 2016; 123: 452-473Crossref PubMed Scopus (216) Google Scholar The gold standard test for the diagnosis and determination of the severity of OSA is in-laboratory polysomnography (PSG).19Kapur V.K. Auckley D.H. Chowdhuri S. et al.Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American Academy of Sleep Medicine clinical practice guideline.J Clin Sleep Med. 2017; 13: 479-504Crossref PubMed Scopus (1247) Google Scholar The 2017 clinical practice guideline for diagnostic testing for adult obstructive sleep apnea from the American Academy of Sleep Medicine (AASM) recommended use of alternative portable monitors for home diagnostic testing for OSA.19Kapur V.K. Auckley D.H. Chowdhuri S. et al.Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American Academy of Sleep Medicine clinical practice guideline.J Clin Sleep Med. 2017; 13: 479-504Crossref PubMed Scopus (1247) Google Scholar In addition to the PSG technologies, high-resolution nocturnal oximetry has been suggested as a low-cost preoperative screening tool for OSA.20Chung F. Liao P. Elsaid H. Islam S. Shapiro C.M. Sun Y. Oxygen desaturation index from nocturnal oximetry: a sensitive and specific tool to detect sleep-disordered breathing in surgical patients.Anesth Analg. 2012; 114: 993-1000Crossref PubMed Scopus (177) Google Scholar For risk stratification in patients with OSA, it is unclear what, if any, specific parameters derived from the PSG or overnight oximetry are associated with postoperative complications. This knowledge is important for risk minimization and enhanced care of patients with known OSA who are undergoing surgery. The objective of this narrative review is to evaluate the literature to determine the association between parameters extracted from portable PSG, in-laboratory PSG, or overnight oximetry and postoperative adverse events. For this review, we obtained pertinent articles from Ovid MEDLINE, Ovid MEDLINE In-Process & Other Non-Indexed Citations, and Embase by using a search method designed by an information specialist. To supplement our database searches, we also performed a citation search of references from primary or review articles. The comprehensive search included terms for “obstructive sleep apnea,” “sleep assessment,” and “perioperative and postoperative complications and adverse events” (e-Tables 1-3). We included studies that (1) used in-laboratory PSG (type I), portable PSG, or overnight oximetry (types II-IV) to diagnose OSA and/or assess patients with OSA; (2) reported on at least one postoperative adverse event; (3) reported on the following sleep parameters: apnea-hypopnea index (AHI), oxygen desaturation index (ODI), cumulative time with oxyhemoglobin saturation (Spo2) < 90% (CT90), minimum Spo2, mean Spo2, or longest apnea duration; and (4) included an adult population aged ≥ 18 years. The search was restricted to English-language articles with a publication date limited to 2008 to December 2017. Studies were selected for inclusion first based on title and abstract review and relevance to the study question and then based on full-text review. We extracted information about study design, sample size, sleep study type and sleep monitor, reported sleep parameters, and postoperative complications. We summarized our findings by using narrative synthesis. The search yielded 1,810 articles, of which 21 fulfilled our inclusion criteria and were included in this review. Of the 21 articles, one was added following review of references from the included studies.21Chung F. Zhou L. Liao P. Parameters from preoperative overnight oximetry predict postoperative adverse events.Minerva Anestesiol. 2014; 80: 1084-1095PubMed Google Scholar Among studies reporting postoperative complications in patients with OSA, 19 studies reported on AHI, five on ODI, two on CT90, five on minimum Spo2, one on mean Spo2, and one on longest apnea duration (Table 1).22Devaraj U. Rajagopala S. Kumar A. Ramachandran P. Devereaux P.J. D'Souza G.A. Undiagnosed obstructive sleep apnea and postoperative outcomes: a prospective observational study.Respiration. 2017; 94: 18-25Crossref PubMed Scopus (31) Google Scholar The majority of studies measured short-term postoperative adverse outcomes (< 72 h). The most frequently observed events included oxygen desaturations and requirements for supplemental oxygen in the postanesthetic care unit. The more serious respiratory (pneumonia, respiratory failure, aspiration), cardiac (arrhythmia, cardiac arrest, acute coronary syndromes, heart failure, cardiogenic shock), and neurologic (cerebrovascular events, altered level of consciousness, delirium) complications were reported less frequently.Table 1Sleep Study and Oximetry Parameters Associated With Postoperative OutcomesStudy/YearNo. of PatientsStudy DesignSleep Study TypeMonitoring DevicePAP UseParameter (Oxygen Desaturation Criteria)OutcomeFindings (Complications vs No Complications)Upper airway surgery Asha’ari et al27Asha'ari Z.A. Rahman J.A. Mohamed A.H. Abdullah K. Leman W.I. Association between severity of obstructive sleep apnea and number and sites of upper airway operations with surgery complications.JAMA Otolaryngol Head Neck Surg. 2017; 143: 239-246Crossref PubMed Scopus (13) Google Scholar/201795Cohort-RLab-PSGCrystal Sapphire (CleveMed)Yes, if using preopAHIPostop CxNSMinimum Spo2Postop CxOR 1.03 for per 5% decrease,aP < .05 vs control group (no complication). mean 68% vs 79%aP < .05 vs control group (no complication).Longest apnea durationPostop CxOR 1.03 per 5-s increase,aP < .05 vs control group (no complication). mean 51 vs 39 saP < .05 vs control group (no complication). Kandasamy et al25Kandasamy T. Wright E.D. Fuller J. Rotenberg B.W. The incidence of early post-operative complications following uvulopalatopharyngoplasty: identification of predictive risk factors.J Otolaryngol Head Neck Surg. 2013; 42: 15Crossref PubMed Scopus (29) Google Scholar/2013345Cohort-RLab-PSGNRNot routineAHIO2 in PACUOR 2.2 for AHI ≥ 22 vs < 22aP < .05 vs control group (no complication).O2 on ward37.4 vs 31.4aP < .05 vs control group (no complication). Kezirian et al24Kezirian E.J. Weaver E.M. Yueh B. Khuri S.F. Daley J. Henderson W.G. Risk factors for serious complication after uvulopalatopharyngoplasty.Arch Otolaryngol Head Neck Surg. 2006; 132: 1091-1098Crossref PubMed Scopus (45) Google Scholar/2006255Nested case-controlLab-PSGNRNRAHIPostop CxMean 53 vs 39aP < .05 vs control group (no complication). Kim et al41Kim J.A. Lee J.J. Jung H.H. Predictive factors of immediate postoperative complications after uvulopalatopharyngoplasty.Laryngoscope. 2005; 115: 1837-1840Crossref PubMed Scopus (44) Google Scholar/2005153Cohort-RLab-PSGNRNRAHIPostop CxMean 68 vs 49aP < .05 vs control group (no complication). Pang et al26Pang K.P. Siow J.K. Tseng P. Safety of multilevel surgery in obstructive sleep apnea: a review of 487 cases.Arch Otolaryngol Head Neck Surg. 2012; 138: 353-357Crossref PubMed Scopus (31) Google Scholar/2012487 (6)bThe number in parentheses indicates the number of patients with complications studied.Cohort-RLevel III oximetryWatchPAT 100 (Itamar Medical)50% preop CPAP trial for 1-2 wkAHIPostop Spo2 desaturationMean AHI 67 vs 47Minimum Spo2Postop Spo2 desaturationMean 61% vs 75%Cardiac surgery Foldvary-Schaefer et al39Foldvary-Schaefer N. Kaw R. Collop N. et al.Prevalence of undetected sleep apnea in patients undergoing cardiovascular surgery and impact on postoperative outcomes.J Clin Sleep Med. 2015; 11: 1083-1089Crossref PubMed Scopus (22) Google Scholar/2015107Cohort-PLab-PSGCrystal Monitor 20HPreop PAP use excludedAHI (≥ 3%)Postop CxNSLVEF (baseline)Mean 44% vs 53% in patients with AHI ≥ 15 vs < 15aP < .05 vs control group (no complication).LVEFNSCT90CT90 > 0 associated with significantly greater BMI, longer intraop ET time, and more prolonged intubation Kaw et al32Kaw R. El Zarif S. Wang L. Bena J. Blackstone E.H. Mehra R. Obesity as an effect modifier in sleep-disordered breathing and postcardiac surgery atrial fibrillation.Chest. 2017; 151: 1279-1287Abstract Full Text Full Text PDF PubMed Scopus (10) Google Scholar/2017190Cohort-RLab-PSGNihon Kohden24% preop useAHI (≥ 3%)OR 1.06 per 5-unit increase in AHIaP < .05 vs control group (no complication). in unadjusted analysis (OR 1.04 in adjusted analysis; P > .05)AFEffect modification with BMI > 32 kg/m2ODI 3%AFNSODI 4%AFNSMinimum Spo2Postop CxNSMinimum Spo2Postop Cx71% vs 78%aP < .05 vs control group (no complication). Kua et al34Kua J. Zhao L.P. Kofidis T. et al.Sleep apnoea is a risk factor for acute kidney injury after coronary artery bypass grafting.Eur J Cardiothorac Surg. 2016; 49: 1188-1194Crossref PubMed Scopus (15) Google Scholar/2016150Cohort-PLevel III oximetryWatchPAT 200 (Itamar Medical)Preop PAP use excludedAHIAHIOR 2.9 for AHI ≥ 15aP < .05 vs control group (no complication). Roggenbach et al33Roggenbach J. Klamann M. von Haken R. Bruckner T. Karck M. Hofer S. Sleep-disordered breathing is a risk factor for delirium after cardiac surgery: a prospective cohort study.Crit Care. 2014; 18: 477Crossref PubMed Scopus (47) Google Scholar/201492Cohort-PLevel III oximetryMiniScreen 4 (Heinen and Löwenstein)Postop CPAP if neededAHI (≥ 3%)DeliriumOR 6.04 for AHI ≥ 19aP < .05 vs control group (no complication).Mean Spo2DeliriumNSMinimum Spo2DeliriumNSCT90DeliriumNS Unosawa et al51Unosawa S. Sezai A. Akahoshi T. et al.Arrhythmia and sleep-disordered breathing in patients undergoing cardiac surgery.J Cardiol. 2012; 60: 61-65Abstract Full Text Full Text PDF PubMed Scopus (16) Google Scholar/201289Cohort-PLevel IV oximetrySAS-2100 (Nihon Kohden)NoAHI (postop)AFNSPVC19.2% vs 3.2% between AHI ≥ 15 vs < 15aP < .05 vs control group (no complication).Minimum Spo2Minimum Spo2 78% vs 87% between postop AHI ≥ 15 vs < 15aP < .05 vs control group (no complication).Vascular surgery Utriainen et al35Utriainen K.T. Airaksinen J.K. Polo O. et al.Sleep apnoea is associated with major cardiac events in peripheral arterial disease.Eur Respir J. 2014; 43: 1652-1660Crossref PubMed Scopus (16) Google Scholar/201482Cohort-PLab-PSGEmbla/Somnologica (Natus)NoAHI (≥ 4%)MACCEHR 5.1 AHI ≥ 20 vs AHI < 20 for a median follow-up of 52 moaP < .05 vs control group (no complication).Bariatric surgery Turan et al40Turan A. You J. Egan C. et al.Chronic intermittent hypoxia is independently associated with reduced postoperative opioid consumption in bariatric patients suffering from sleep-disordered breathing.PLoS One. 2015; 10: e0127809Crossref PubMed Scopus (21) Google Scholar/2015218Cohort-RLab-PSGNR63% using preop CPAPCT90Opioid consumptionDecrease in median postop opioid consumption by 16% per 5% increase in CT90aP < .05 vs control group (no complication).Minimum Spo2Opioid consumptionNSAHIOpioid consumptionNS Weingarten et al30Weingarten T.N. Flores A.S. McKenzie J.A. et al.Obstructive sleep apnoea and perioperative complications in bariatric patients.Br J Anaesth. 2011; 106: 131-139Abstract Full Text Full Text PDF PubMed Scopus (106) Google Scholar/2011797Cohort-RLab-PSGNR82% using preop PAP; postop PAP applied if preop useAHI (≥ 2 or 4)Postop CxNS among AHI categories (mild 5 ≤ AHI < 15, moderate 15 ≤ AHI < 30, severe AHI ≥ 30)Other populations undergoing surgery Chung et al21Chung F. Zhou L. Liao P. Parameters from preoperative overnight oximetry predict postoperative adverse events.Minerva Anestesiol. 2014; 80: 1084-1095PubMed Google Scholar/2014573Cohort-PLevel IV oximetryPULSOX-300i (Konica Minolta Sensing)None, undiagnosed OSAODI 4Postop CxOR 2.2 for ODI > 29aP < .05 vs control group (no complication).CT90Postop CxOR 2.6 for CT90 > 7%aP < .05 vs control group (no complication).Mean Spo2Postop CxOR 2.8 for mean Spo2 < 93%aP < .05 vs control group (no complication). Devaraj et al22Devaraj U. Rajagopala S. Kumar A. Ramachandran P. Devereaux P.J. D'Souza G.A. Undiagnosed obstructive sleep apnea and postoperative outcomes: a prospective observational study.Respiration. 2017; 94: 18-25Crossref PubMed Scopus (31) Google Scholar/2017245Cohort-PLevel III oximetryApneaLink Plus (ResMed)None, undiagnosed OSAAHI (≥ 3%)Postop CxOR 3.6 for AHI ≥ 5 (within 7 d postop)aP < .05 vs control group (no complication).OR 3.5 for AHI ≥ 5 (within 30 d postop)aP < .05 vs control group (no complication).Postop desaturationOR 6 for AHI ≥ 5 Hwang et al37Hwang D. Shakir N. Limann B. et al.Association of sleep-disordered breathing with postoperative complications.Chest. 2008; 133: 1128-1134Abstract Full Text Full Text PDF PubMed Scopus (187) Google Scholar/2008172Cohort-PLevel IV oximetryNRNone, undiagnosed OSAODI 4Postop CxOR 7.0 for ODI ≥ 5aP < .05 vs control group (no complication).CT90Postop CxMean 21% vs 10%aP < .05 vs control group (no complication). Kaw et al53Kaw R. Bhateja P. Paz Y.M.H. et al.Postoperative complications in patients with unrecognized obesity hypoventilation syndrome undergoing elective noncardiac surgery.Chest. 2016; 149: 84-91Abstract Full Text Full Text PDF PubMed Scopus (70) Google Scholar/2016519Cohort-RLab-PSGNR24% preop PAP useAHIICU LOSAHI (per 15-unit increase) associated with increased ICU LOS in OHS cohort (β coefficient, 0.009)aP < .05 vs control group (no complication). Mador et al42Mador M.J. Goplani S. Gottumukkala V.A. et al.Postoperative complications in obstructive sleep apnea.Sleep Breath. 2013; 17: 727-734Crossref PubMed Scopus (40) Google Scholar/2013284Cohort-RLab-PSGNRYesAHIPostop CxOR 2.0 for AHI ≥ 5 vs < 5aP < .05 vs control group (no complication).OR 2.3 for AHI 5 to < 30 vs AHI < 5aP < .05 vs control group (no complication).OR 1.92 for AHI 5 to <15 vs AHI < 5 (NS)OR 2.13 for AHI ≥ 30 vs AHI < 5 (NS)Respiratory CxOR 2.05 for AHI ≥ 5 vs < 5aP < .05 vs control group (no complication).OR 2.18 for AHI 5 to < 15 vs AHI < 5aP < .05 vs control group (no complication).OR 2.01 for AHI 15 to < 30 vs AHI < 5 (NS)OR 2.07 AHI ≥ 30 vs < 5 (NS)Cardiac CxNS Mason et al38Mason M. Hernández Sánchez J. Vuylsteke A. Smith I. Association between severity of untreated sleep apnoea and postoperative complications following major cardiac surgery: a prospective observational cohort study.Sleep Med. 2017; 37: 141-146Crossref PubMed Scopus (3) Google Scholar/2017122Cohort-PLevel IV oximetryPULSOX-300i (Konica Minolta Sensing)NRODI 4Postop CxOR 1.1 per increase by 1 unitaP < .05 vs control group (no complication).NS for arrhythmiaICU LOSNS Mutter et al31Mutter T.C. Chateau D. Moffatt M. Ramsey C. Roos L.L. Kryger M. A matched cohort study of postoperative outcomes in obstructive sleep apnea: could preoperative diagnosis and treatment prevent complications?.Anesthesiology. 2014; 121: 707-718Crossref PubMed Scopus (175) Google Scholar/201420,442Cohort-RLab-PSGNRNRAHIRespiratory CxOR 2.7 for AHI ≥ 30aP < .05 vs control group (no complication).19,405Cohort-RLab-PSGNRNRAHICardiac CxOR 2.2 for cardiac Cx undiagnosed OSA vs OR 0.75 for diagnosed OSAaP < .05 vs control group (no complication).OR 2.7 for cardiac Cx in severe undiagnosed OSA + AHI ≥ 30 vs control groupaP < .05 vs control group (no complication). Subramani et al12Subramani Y. Nagappa M. Wong J. Patra J. Chung F. Death or near-death in patients with obstructive sleep apnoea: a compendium of case reports of critical complications.Br J Anaesth. 2017; 119: 885-899Abstract Full Text Full Text PDF PubMed Scopus (47) Google Scholar/20173Case reportsLab-PSGNRNRAHICritical eventsMean AHI 30, all patients with AHI > 15AF = atrial fibrillation; AHI = apnea-hypopnea index (expressed in events per hour); Cohort-P = prospective cohort; Cohort-R = retrospective cohort; CT90 = cumulative time percentage with Spo2 < 90%; Cx = complication; ET = endotracheal tube; HR = hazard ratio; intraop = intraoperative; Lab = laboratory; LOS = length of stay; LVEF = left ventricular ejection fraction; MACCE = major adverse cardiac and cerebrovascular events (includes cardiac death, myocardial infarction, coronary revascularization, angina pectoris requiring hospitalization, and stroke as a combined end point); NR = not reported; NS = not significant; O2 = oxygen; ODI = oxygen desaturation index; OHS = obesity hypoventilation syndrome; PACU = postanesthesia care unit; PAP = positive airway pressure; postop = postoperative; preop = preoperative; PSG = polysomnography; PVC = premature ventricular contraction; Spo2 = oxyhemoglobin saturation.a P < .05 vs control group (no complication).b The number in parentheses indicates the number of patients with complications studied. Open table in a new tab AF = atrial fibrillation; AHI = apnea-hypopnea index (expressed in events per hour); Cohort-P = prospective cohort; Cohort-R = retrospective cohort; CT90 = cumulative time percentage with Spo2 < 90%; Cx = complication; ET = endotracheal tube; HR = hazard ratio; intraop = intraoperative; Lab = laboratory; LOS = length of stay; LVEF = left ventricular ejection fraction; MACCE = major adverse cardiac and cerebrovascular events (includes cardiac death, myocardial infarction, coronary revascularization, angina pectoris requiring hospitalization, and stroke as a combined end point); NR = not reported; NS = not significant; O2 = oxygen; ODI = oxygen desaturation index; OHS = obesity hypoventilation syndrome; PACU = postanesthesia care unit; PAP = positive airway pressure; postop = postoperative; preop = preoperative; PSG = polysomnography; PVC = premature ventricular contraction; Spo2 = oxyhemoglobin saturation. The AHI is defined as the total number of apneas and hypopneas per hour of sleep.23The AASM manual for the scoring of sleep and associated events. American Academy of Sleep Medicine website. https://aasm.org/clinical-resources/scoring-manual/. Accessed October 18, 2018.Google Scholar The current AASM definition of an apnea is a reduction in airflow of at least 90% lasting at least 10 seconds, whereas a hypopnea is defined as a reduction in airflow of at least 30% with a concomitant decrease in Spo2 by 3% to 4% from pre-event baseline and/or the event is associated with an arousal.23The AASM manual for the scoring of sleep and associated events. American Academy of Sleep Medicine website. https://aasm.org/clinical-resources/scoring-manual/. Accessed October 18, 2018.Google Scholar The diagnosis and severity of OSA are determined using AHI thresholds: no OSA is an AHI < 5 events per hour, mild is an AHI ≥ 5 to < 15 events per hour, moderate is an AHI ≥ 15 to < 30 events p" @default.
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• W2896642743 title "Sleep Study and Oximetry Parameters for Predicting Postoperative Complications in Patients With OSA" @default.
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• W2896642743 cites W1964518140 @default.
• W2896642743 cites W1966045717 @default.
• W2896642743 cites W1968895937 @default.
• W2896642743 cites W1978388061 @default.
• W2896642743 cites W1986147394 @default.
• W2896642743 cites W1988282764 @default.
• W2896642743 cites W2011114870 @default.
• W2896642743 cites W2025819152 @default.
• W2896642743 cites W2026506771 @default.
• W2896642743 cites W2032233607 @default.
• W2896642743 cites W2044660354 @default.
• W2896642743 cites W2054954926 @default.
• W2896642743 cites W2068017066 @default.
• W2896642743 cites W2071070954 @default.
• W2896642743 cites W2071545991 @default.
• W2896642743 cites W2088792665 @default.
• W2896642743 cites W2092218545 @default.
• W2896642743 cites W2093457132 @default.
• W2896642743 cites W2109954025 @default.
• W2896642743 cites W2110184725 @default.
• W2896642743 cites W2113743226 @default.
• W2896642743 cites W2117834225 @default.
• W2896642743 cites W2128764603 @default.
• W2896642743 cites W2138238799 @default.
• W2896642743 cites W2139704316 @default.
• W2896642743 cites W2144432618 @default.
• W2896642743 cites W2145847102 @default.
• W2896642743 cites W2149131321 @default.
• W2896642743 cites W2149982458 @default.
• W2896642743 cites W2150448993 @default.
• W2896642743 cites W2156984520 @default.
• W2896642743 cites W2161913216 @default.
• W2896642743 cites W2163446124 @default.
• W2896642743 cites W2169566380 @default.
• W2896642743 cites W2172953010 @default.
• W2896642743 cites W2222534728 @default.
• W2896642743 cites W2223434651 @default.
• W2896642743 cites W2229754007 @default.
• W2896642743 cites W2302416959 @default.
• W2896642743 cites W2335449614 @default.
• W2896642743 cites W2339880150 @default.
• W2896642743 cites W2402103471 @default.
• W2896642743 cites W2411947931 @default.
• W2896642743 cites W2416011765 @default.
• W2896642743 cites W2441147923 @default.
• W2896642743 cites W2481679598 @default.
• W2896642743 cites W2548732383 @default.
• W2896642743 cites W2553491817 @default.
• W2896642743 cites W2559327460 @default.
• W2896642743 cites W2592935635 @default.
• W2896642743 cites W2606201056 @default.
• W2896642743 cites W2612940703 @default.
• W2896642743 cites W2613119364 @default.
• W2896642743 cites W2725629561 @default.
• W2896642743 cites W2763869758 @default.
• W2896642743 cites W2767127523 @default.
• W2896642743 cites W2768054782 @default.
• W2896642743 cites W4246768900 @default.
• W2896642743 cites W4378610989 @default.
• W2896642743 cites W837518111 @default.
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