• Rabail Chaudhry, Colin Suen, Talha Mubashir, Jean Wong, Clodagh M Ryan, Babak Mokhlesi, and Frances Chung.
• From the Department of Anesthesia, Toronto Western Hospital, University Health Network (RC, CS, TM, JW, FC), Department of Anesthesia, University of Toronto (RC, CS, JW, FC), Centre for Sleep Health and Research, Toronto General Hospital, Toronto, Ontario, Canada (CMR) and Section of Pulmonary and Critical Care, Sleep Disorders Center, University of Chicago, Chicago, Illinois, USA (BM).
• Eur J Anaesthesiol. 2020 Aug 1; 37 (8): 688-695.

BackgroundThere is limited and conflicting data on whether sleep-disordered breathing (SDB) is associated with postoperative major cardiovascular and cerebrovascular events (MACCE), and mortality.ObjectivesTo determine whether SDB is associated with increased risks of MACCE, mortality and length of hospital stay.DesignRetrospective cohort analysis from the Nationwide Inpatient Sample.SettingAdults who underwent elective abdominal, orthopaedic, prostatic, gynaecological, thoracic, transplant, vascular or cardiac surgery in the United States of America between 2011 and 2014.PatientsThe study cohort included 1813 974 surgical patients, of whom 185 615 (10.2%) had SDB. Emergency or urgent surgical procedures were excluded.Main Outcome MeasuresThe incidences of MACCE, respiratory and vascular complications, in-hospital mortality and mean length of hospital stay were stratified by SDB. Linear and logistic regression models were constructed to determine the independent association between SDB and outcomes of interest.ResultsThe incidences of MACCE [25.3 vs. 19.8%, odds ratio (OR) 1.20, P < 0.001] and respiratory complications (11.75 vs. 8.0%, OR 1.43, P < 0.001) were significantly higher in patients with SDB than in those without SDB. SDB was associated with higher rates of atrial fibrillation (14.7 vs. 10.8%, P < 0.001), other arrhythmias (6.0 vs. 5.4%, P < 0.001) and congestive heart failure (9.8 vs. 7.1%, P < 0.001). SDB patients had a lower rate of myocardial infarction (3.1 vs. 3.4%, OR 0.69, P < 0.001), lower mortality (0.6 vs. 1.3%, P < 0.001) and shorter length of hospital stay (4.8 vs. 5.2 days, P < 0.001).ConclusionSDB was associated with increased risks of MACCE, and respiratory and vascular complications, but had a lower incidence of in-hospital mortality and shorter length of hospital stay.

12 keywords...

hide…