Background Obstructive sleep apnoea (OSA) has been previously reported as an independent risk factor for intra and post operative adverse events.1
Early diagnosis of sleep disordered breathing and initiation of CPAP treatment was suggestive to improve operative outcomes.2
Objectives To determine the prevalence of sleep apnoea in a surgical population and establish the role of CPAP on peri-operative outcomes in patients with OSA.
Methods A retrospective study was performed in a university hospital between 1st June 2013 and 1st June 2015 and included 160 surgical patients investigated for OSA. Sleep apnoea was defined as dip rate >10 events/hour associated with a desaturation of 4% below the baseline. Statistical analysis was performed with STATA v10 software.
Results From 160 surgical patients included, 33.1% (53) were females and average age was 54 years. Prevalence of OSA was 44.3% (71/160) and 12.5% (20/160) had severe OSA defined as a dip rate >30 events/hour.
Following sleep investigations, 68 patients had surgical interventions: 48.5% (33/68) trauma and orthopaedics, 17.6% (12/68) general surgery, 10.2% (7/68) urology, 8.8% (6/68) gynaecology, 7.3% (5/68) colorectal, 4.4% (3/68) ENT. From 68 patients undergoing surgical procedures, 44.1% (30/68) were diagnosed with OSA and started on CPAP prior to surgery.
Peri-operative adverse events were not significantly related to OSA when compared to non OSA patients: intra operative desaturations (23.3% vs 26.3%) and prolonged recovery stay (53.3% vs 55.2%).
OSA patients had a lower hospital stay compared to non OSA group (1.7 vs 3.1 days).
Conclusions We have identified a high prevalence of sleep apnoea of 44% in surgical population. CPAP treatment was found effective in improving operative outcomes of patients with OSA, further studies being needed to confirm these results. Routine pre-assessment screening for OSA followed by sleep investigations for initiation of CPAP prior to surgery is recommended.
References 1 Vasu TS, Grewal R, Doghramji K. Obstructive sleep apnoea syndrome and perioperative complications. J Clin Sleep Med. 2012;8(2):199–207
2 Gross JB, et al. Practice guidelines for the perioperative management of obstructive sleep apnea: ASA task force on perioperative management of OSA. Anesthesiology 2014;120
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