Postoperative complications after elective coronary artery bypass grafting surgery in patients with sleep-disordered breathing
| Autor: | Michael Arzt, Daniele Camboni, Florian Zeman, Christof Schmid, York Zausig, Marzena Drzymalski, Miriam Fauser, Sarah Ripfel, Sigrid Wittmann, Lars S. Maier, Teresa Weizenegger, Bernhard Floerchinger, Stefan Wagner, Maria Tafelmeier |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Central sleep apnea 030204 cardiovascular system & hematology Coronary artery disease 03 medical and health sciences Postoperative Complications 0302 clinical medicine Risk Factors Internal medicine medicine Humans Coronary Artery Bypass Aged Retrospective Studies Sleep Apnea Obstructive business.industry Sleep apnea General Medicine Odds ratio Length of Stay Middle Aged medicine.disease Sleep Apnea Central Confidence interval nervous system diseases respiratory tract diseases Cardiac surgery Obstructive sleep apnea 030228 respiratory system Elective Surgical Procedures Breathing Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Clinical Research in Cardiology. 107:1148-1159 |
| ISSN: | 1861-0692 1861-0684 |
| Popis: | Sleep-disordered breathing (SDB) may increase the risk of postoperative complications in patients after cardiac surgery. This study evaluated the length of hospital stay as well as postoperative cardiac, respiratory, and renal complications after elective coronary artery bypass grafting (CABG) in patients without SDB, with central sleep apnea (CSA), or with obstructive sleep apnea (OSA). The presence and type of SDB had been assessed with polygraphic recordings in 100 patients the night before elective CABG surgery. SDB was defined as an apnea–hypopnea index (AHI) of ≥ 15/h. Prolonged length of hospital stay (LOS) and postoperative hemodynamic instability due to any cause were retrospectively evaluated as primary endpoints and cardiac, respiratory, and renal complications as secondary endpoints. 37% of patients had SDB, 14% CSA, and 23% OSA. LOS differed significantly between patients without SDB and those with CSA and OSA [median (25;75. percentile): 8.0 days (7.5;11.0) vs. 9.5 days (7.0;12.5) vs. 12.0 days (9.0;17.0), Kruskal–Wallis test between three groups: p = 0.023; OSA vs. no SDB: p = 0.005]. AHI was significantly associated with prolonged LOS [> 9 days; odds ratio (OR) (95% confidence interval): 1.047 (1.001;1.095), p = 0.044]. Prolonged need of vasopressors (≥ 48 h) was observed in 36% of patients without SDB, in 64% with CSA, and in 62% with OSA (p = 0.037). AHI was significantly associated with prolonged (≥ 48 h) need of vasopressors [OR (95% CI): 1.052 (1.002;1.104), p = 0.040], independent of any confounders. SDB, particularly OSA, is associated with prolonged LOS after CABG, independent of known confounders. Prolonged LOS in patients with SDB may be due to increased postoperative hemodynamic instability due to any cause. |
| Databáze: | OpenAIRE |
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