Chest
Original Research: Sleep MedicineAssociation of Sleep-Disordered Breathing With Postoperative Complications
Section snippets
Patients
We reviewed the medical records of elective surgery patients who were at least 18 years of age (performed on an inpatient or outpatient basis) who underwent preoperative screening for SDB based on an established clinical protocol at North Shore University Hospital, a tertiary care hospital in New York, between July 2004 and November 2006. During preoperative assessment in the preanesthesia testing unit, patients without a prior diagnosis of OSA but with at least two clinical features suggestive
Statistical Analysis
The Fisher exact test was used to determine whether there was a statistically significant difference in perioperative complication rates between the ODI4% ≥ 5 and ODI4% < 5 groups. The Fisher exact test and Mann-Whitney test were used to determine which of the candidate risk factors were individually associated with a perioperative complication. The Cochran-Armitage trend test was used to test for trends across the ODI4% severity groups. The asymptotic test for the Somer D(C/R), which measures
Results
A total of 172 patients aged 27 to 85 years were evaluated. The overall mean (± SD) age was 54.5 ± 13.6 years. Other relevant demographics are included in Table 1 and Table 2; the categories of surgical procedures are included in Table 3.
Home nocturnal oximetry testing revealed that 98 patients (57%) had an ODI4% with five or more desaturations per hour (ODI4%≥ 5) and 74 patients (43%) had an ODI4% with less than five desaturations per hour (ODI4%< 5). There were 58 patients (33.7%) with an ODI
Discussion
While OSA is a prevalent condition with the potential to cause significant adverse effects in the perioperative setting, the majority of patients remain without a diagnosis.3 This necessitates screening during preoperative assessment to facilitate the implementation of strategies to minimize the postoperative risk. Since clinical history is an unreliable indicator of the presence of OSA, a more effective screening modality is necessary.6 Overnight polysomnography is the “gold standard” for the
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