High risk for obstructive sleep apnea hypopnea syndrome predicts new onset atrial fibrillation after cardiac surgery: a retrospective analysis
| Autor: | Manuel Bautista, Juan F Viles Gonzalez, Rajesh Sonani, Diwas Shahi, Palak Patel, Rafael Rodriguez, Parth Bhatt, Sanjay R. Patel, Abhishek Deshmukh, Harmeet Gill, Samir V. Patel, Ajai Rajabalan |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Coronary Artery Disease 030204 cardiovascular system & hematology Severity of Illness Index Article 03 medical and health sciences Coronary artery bypass surgery Postoperative Complications 0302 clinical medicine Risk Factors Internal medicine Atrial Fibrillation Positive airway pressure medicine Humans Coronary Artery Bypass Risk factor Retrospective Studies Sleep Apnea Obstructive business.industry Sleep apnea Atrial fibrillation Retrospective cohort study Prognosis medicine.disease Obstructive sleep apnea Otorhinolaryngology Female Neurology (clinical) business Hypopnea 030217 neurology & neurosurgery |
| Zdroj: | Sleep Breath |
| ISSN: | 1522-1709 1520-9512 |
| DOI: | 10.1007/s11325-018-1645-3 |
| Popis: | PURPOSE: Obstructive sleep apnea hypopnea syndrome (OSAHS) is highly prevalent in patients undergoing coronary artery bypass surgery (CABG). OSAHS is a risk factor for the development of atrial fibrillation (AF) but the risk of AF in patients who are high-risk for OSAHS is unclear. METHODS: A retrospective study was conducted on consecutive patients undergoing CABG from 2013-2015 without AF pre-operatively. Patients were categorized as low-risk for OSAHS, high-risk for OSAHS, or diagnosed OSAHS based on medical records review. All diagnosed OSAHS patients were on active treatment with positive airway pressure. Outcomes assessed were postoperative AF (POAF), postoperative length of stay, re-intubation, in-hospital mortality and cost of hospitalization. RESULTS: Out of 209 eligible patients, 66.5% were low-risk for OSAHS, 18.7% high-risk for OSAHS, and 14.8% diagnosed/treated for OSAHS. POAF developed in 96 patients (45.9%) with greater frequency in high-risk OSAHS patients (69.2% high-risk, 41.9% low-risk, 40.3% diagnosed/treated, p=0.01). In analyses adjusted for age, sex, ethnicity and comorbidities, high-risk for OSAHS was associated with 2.9 greater odds (95% CI [1.2, 7.3], p=0.02) for POAF while diagnosed/treated OSAHS was not associated with elevated risk (OR=1.4, 95% CI [0.6, 3.6], p=0.50) compared to patients at low risk for OSAHS. CONCLUSIONS: High risk for OSAHS is an independent predictor for POAF in patients undergoing CABG. In contrast, patients diagnosed and treated for their OSAHS are not at elevated risk of POAF. These findings support evaluation of a standardized OSAHS screening and treatment program as part of the pre-operative evaluation for elective CABG. |
| Databáze: | OpenAIRE |
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