Frédéric Sériès1,2, Camille Genest3, Maxime Martin4, Isabelle Boutin3, Simon Marceau5, Jean Bussières4, Caroline Minville3. 1. Department of Respirology and Thoracic Surgery, IUCPQ, Université Laval, Québec, Canada. frederic.setries@med.ulaval.ca. 2. Centre de Pneumologie, IUCPQ, 2725 Chemin Sainte Foy, Québec, PQ, G1V 4G5, Canada. frederic.setries@med.ulaval.ca. 3. Department of Respirology and Thoracic Surgery, IUCPQ, Université Laval, Québec, Canada. 4. Department of Surgery, IUCPQ, Université Laval, Québec, Canada. 5. Department of Anesthesiology, IUCPQ, Université Laval, Québec, Canada.
Abstract
BACKGROUND: Obstructive sleep apnea (OSA) patients are at high risk of postoperative complications following bariatric surgery. The aim of our study was to compare peri- and postoperative outcomes in OSA patients awaiting laparoscopic bariatric surgery who were prescribed CPAP treatment or not before surgery using nocturnal home oximetry and capillary blood gas measurements. METHODS: Data on 1094 eligible patients were analyzed. In accordance with our algorithm, those with ODI < 25/h and pCO2 < 45 mmHg (358 mild/moderate apnea and 447 non-apneic) underwent surgery without previous treatment, whereas those with an ODI ≥ 25/h (n = 289) were prescribed CPAP. We compared peri- and postoperative outcomes in treated and untreated patients. RESULTS: Treated patients were significantly older with a higher body mass index and a higher percentage of men than non-apneic and untreated OSA. Hypertension and diabetes were significantly more prevalent in the treated and untreated OSA patients than in the non-apneic. Regarding the occurrence of cardiopulmonary complications, the incidence of cardiac arrhythmia was higher in the treated patients than in the non-apneic and the untreated OSA (2.4%; 0.6 and 0.5%, p = 0.03). The slightly longer length of hospital stay seen in treated patients compared to those of other groups (2.8 ± 1.7; 2.6 ± 2.1 and 2.6 ± 1.8 days, p = 0.03) was no longer observed after adjusting for age and BMI. CONCLUSIONS: There is no risk increase for complications following bariatric surgery in untreated patients presenting mild/moderate OSA identified by a noninvasive screening algorithm.
BACKGROUND: Obstructive sleep apnea (OSA) patients are at high risk of postoperative complications following bariatric surgery. The aim of our study was to compare peri- and postoperative outcomes in OSA patients awaiting laparoscopic bariatric surgery who were prescribed CPAP treatment or not before surgery using nocturnal home oximetry and capillary blood gas measurements. METHODS: Data on 1094 eligible patients were analyzed. In accordance with our algorithm, those with ODI < 25/h and pCO2 < 45 mmHg (358 mild/moderate apnea and 447 non-apneic) underwent surgery without previous treatment, whereas those with an ODI ≥ 25/h (n = 289) were prescribed CPAP. We compared peri- and postoperative outcomes in treated and untreated patients. RESULTS: Treated patients were significantly older with a higher body mass index and a higher percentage of men than non-apneic and untreated OSA. Hypertension and diabetes were significantly more prevalent in the treated and untreated OSA patients than in the non-apneic. Regarding the occurrence of cardiopulmonary complications, the incidence of cardiac arrhythmia was higher in the treated patients than in the non-apneic and the untreated OSA (2.4%; 0.6 and 0.5%, p = 0.03). The slightly longer length of hospital stay seen in treated patients compared to those of other groups (2.8 ± 1.7; 2.6 ± 2.1 and 2.6 ± 1.8 days, p = 0.03) was no longer observed after adjusting for age and BMI. CONCLUSIONS: There is no risk increase for complications following bariatric surgery in untreated patients presenting mild/moderate OSA identified by a noninvasive screening algorithm.
Authors: Olalla Castro-Añón; Luis A Pérez de Llano; Sandra De la Fuente Sánchez; Rafael Golpe; Lidia Méndez Marote; Julián Castro-Castro; Arturo González Quintela Journal: PLoS One Date: 2015-02-11 Impact factor: 3.240