Postoperative Sleep-Disordered Breathing in Patients Without Preoperative Sleep Apnea
| Autor: | Frances Chung, Pu Liao, Weimin Kang, Babak Mokhlesi, Maged Andrawes, Colin M. Shapiro, Yiliang Yang |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Time Factors Severity of Illness Index Sleep Apnea Syndromes stomatognathic system Risk Factors Severity of illness Humans Medicine Prospective Studies Prospective cohort study Adverse effect Lung Aged Ontario Chi-Square Distribution business.industry Incidence Respiration Smoking Age Factors Sleep apnea Perioperative Middle Aged medicine.disease Sleep in non-human animals nervous system diseases respiratory tract diseases Logistic Models Treatment Outcome Anesthesiology and Pain Medicine Surgical Procedures Operative Anesthesia Multivariate Analysis Breathing Female Sleep business Chi-squared distribution |
| Zdroj: | Anesthesia & Analgesia. 120:1214-1224 |
| ISSN: | 0003-2999 |
| Popis: | Recently published data show that postoperative apnea-hypopnea index (AHI) is significantly increased in some patients without preoperative sleep apnea. These patients may be at risk of developing perioperative adverse events related to sleep-disordered breathing (SDB). The objective of this study was to investigate the incidence and predictors of postoperative moderate-to-severe SDB (AHI15 events/h) in patients without sleep apnea preoperatively.In a prospective observational fashion, patients were invited to undergo sleep studies with a portable device (Embletta X100) preoperatively at home and postoperatively on the first and third night after surgery in the hospital or at home. The primary outcome was the incidence of postoperative moderate-to-severe SDB (AHI15 events/h) in non-sleep apnea patients (preoperative AHI ≤ 5 events/h). Logistic regression was used to evaluate the association of clinical factors and preoperative sleep parameters with the occurrence of postoperative moderate-to-severe SDB.A total of 120 non-sleep apnea patients completed the study, of which 31 (25.8% [95% confidence interval: 18.3%-34.6%]) patients were found to have AHI15 events/h on postoperative night 1 and/or postoperative night 3 (postoperative SDB group), and 89 (74%) patients had an AHI ≤ 15 events/h on both postoperative night 1 and 3 (postoperative non-SDB group). The patients in the postoperative SDB group were older (60 ± 13 vs 53 ± 12 years, P = 0.008) with more smokers (32.3% vs 15.7%, P = 0.048) and had a greater increase in the obstructive apnea index (adjusted P = 0.0003), central apnea index (adjusted P = 0.0012), and hypopnea index (adjusted P = 0.0004). Multivariate logistic regression analysis found that age and preoperative respiratory disturbance index (RDI) were significantly associated with the occurrence of postoperative moderate-to-severe SDB, P = 0.018 and P = 0.006, respectively. The sensitivity privilege cutoff of RDI at 4.9 events/h identified 70.2% to 96.4%patients developing postoperative moderate-to-severe SDB.At least 18.3% of non-sleep apnea patients developed moderate-to-severe SDB after surgery. Age and preoperative RDI were associated with the occurrence of postoperative moderate-to-severe SDB. |
| Databáze: | OpenAIRE |
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