OBSTRUCTIVE sleep apnea (OSA) severity may hold the key to predicting postoperative cardiorespiratory complications, according to a new study involving over 6,700 patients. Researchers identified critical risk factors for complications within 30 days of hospital discharge, shedding light on a population particularly vulnerable to adverse outcomes.
The study analyzed patients who underwent polysomnography, a diagnostic test for OSA, and subsequent surgeries under general anesthesia. Researchers found that 5.3% of participants experienced cardiorespiratory complications or death postoperatively. Significant predictors included advanced age (65+ years increased odds by 2.67), a BMI of 35 or higher (1.43 times greater risk), and over 4.7% of sleep time spent with oxygen saturation below 90%.
Cardiothoracic procedures posed the greatest threat, with an odds ratio of nearly 8.0. However, even for non-cardiothoracic surgeries, factors like age, oxygen saturation, and preexisting cardiorespiratory conditions remained significant. Notably, the time between OSA diagnosis and surgery also played a role; patients undergoing surgery 5 or more years after diagnosis had a 32% increased risk.
The findings underscore the importance of tailored perioperative care for patients with OSA, especially those identified as high-risk by these metrics. With a predictive risk score offering an area under the receiver operating characteristic curve of 0.7, this study provides a foundation for clinicians to refine postoperative protocols and improve patient outcomes.
Reference: Azzopardi M et al. Identifying risk of postoperative cardiorespiratory complications in OSA. Chest. 2024;166(5):1197-1208.
