HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text (PDF) All Versions of this Article: chest.07-1488v1 133/5/1128    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Google Scholar Articles by Hwang, D. Articles by Greenberg, H. PubMed PubMed Citation Articles by Hwang, D. Articles by Greenberg, H.

Association of Sleep-Disordered Breathing With Postoperative Complications

North Shore-Long Island Jewish Medical Center

dennishwangmd{at}yahoo.com

Abstract

Background: Obstructive sleep apnea (OSA) is associated with increased perioperative risk, but the incidence of postoperative complications and the severity of OSA associated with increased risk have not been established. We investigated the relationship between intermittent hypoxemia measured by home nocturnal oximetry with the occurrence of postoperative complications in patients with clinical signs of OSA identified during preoperative assessment for elective surgery.

Methods: This study was performed at a tertiary care hospital. Home nocturnal oximetry was performed on elective surgical patients with clinical features of OSA. The number of episodes per hour of oxygen desaturations 4% or greater (ODI4%) was determined. Subjects with five or more desaturations per hour (ODI4%5) were compared to those with an ODI4%<5. Hospital records were reviewed to assess the incidence and type of postoperative complications.

Results: 172 patients were investigated as part of this study. No significant differences were observed between groups in age, body mass index, number of medical co-morbidities, or smoking history. Patients with an ODI4%5 had a significantly higher rate of postoperative complications than those with ODI4%<5 (15.3% vs. 2.7%; p<0.01.), adjusted OR 7.2 (95%CI 1.5, 33.3; p=0.012). The complication rate also increased with increasing ODI severity (13.8% vs.17.5% in patients with an ODI4% 5-15 vs. ODI4%15; p=0.01) Complications were respiratory (9), cardiovascular (5), gastrointestinal (1), and bleeding (2). Hospital length of stay was similar in both groups.

Conclusion: An ODI4%5 determined by home nocturnal oximetry, in patients with clinical features of OSA, is associated with an increased rate of postoperative complications.

Key Words: Sleep disordered breathing • sleep apnea syndromes • oximetry • surgery • postoperative complications