Obstructive sleep apnoea and perioperative complications in bariatric patients
Open accessAbstract
Background The objective of this study was to determine the relationship between perioperative complications and the severity of obstructive sleep apnoea (OSA) in patients undergoing bariatric surgery who had undergone preoperative polysomnography (PSG).Methods The records of 797 patients, age >18 yr, who underwent bariatric operations (442 open and 355 laparoscopic procedures) at Mayo Clinic and were assessed before operation by PSG, were reviewed retrospectively. OSA was quantified using the apnoea-hypopnoea index (AHI) as none (≤ 4), mild (5-15), moderate (16-30), and severe (≥ 31). Pulmonary, surgical, and 'other' complications within the first 30 postoperative days were analysed according to OSA severity. Logistic regression was used to assess the multivariable association of OSA, age, sex, BMI, and surgical approach with postoperative complications.Results Most patients with OSA (93%) received perioperative positive airway pressure therapy, and all patients were closely monitored after operation with pulse oximetry on either regular nursing floors or in intensive or intermediate care units. At least one postoperative complication occurred in 259 patients (33%). In a multivariable model, the overall complication rate was increased with open procedures compared with laparoscopic. In addition, increased BMI and age were associated with increased likelihood of pulmonary and other complications. Complication rates were not associated with OSA severity.Conclusions In obese patients evaluated before operation by PSG before bariatric surgery and managed accordingly, the severity of OSA, as assessed by the AHI, was not associated with the rate of perioperative complications. These results cannot determine whether unrecognized and untreated OSA increases risk.
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Meta-analysis of observational studies suggested that patients with obstructive sleep apnea or related disorders were more likely to sustain atrial fibrillation (OR 1.51, 95% CI 1.36 to 1.69).
“Meta-analysis of observational studies suggested that patients with obstructive sleep apnea or related disorders were more likely to sustain atrial fibrillation (OR 1.51, 95% CI 1.36 to 1.69) or hypoxemia (WMD − 3.8%, 95% CI − 5.4% to − 2.2%) [45–59].”
Meta-analysis of observational studies suggested that patients with obstructive sleep apnea or related disorders were more likely to sustain hypoxemia (WMD −3.8%, 95% CI −5.4% to −2.2%).
“Meta-analysis of observational studies suggested that patients with obstructive sleep apnea or related disorders were more likely to sustain atrial fibrillation (OR 1.51, 95% CI 1.36 to 1.69) or hypoxemia (WMD − 3.8%, 95% CI − 5.4% to − 2.2%) [45–59].”
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- Authors
- Weingarten, T. N., Flores, A. S., McKenzie, J. A., Nguyen, L. T., Robinson, W. B., Kinney, T. M., Siems, B. T., Wenzel, P. J., Sarr, M. G., Marienau, M. S., Schroeder, D. R., Olson, E. J., Morgenthaler, T. I., Warner, D. O., & Sprung, J.
- Affiliations
- Mayo Clinic (US)
- Venue
- British Journal of Anaesthesia
- Publisher
- Elsevier BV
- Published
- 2011-01
- Volume
- 106
- Issue
- 1
- Pages
- 131-139
- ISSN
- 0007-0912 (ISSN-L)
- OpenAlex
- W2161913216
- Cited by
- 146
- References
- 37
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 6 · 2023: 6 · 2022: 7 · 2021: 10 · 2020: 10 · 2019: 9 · 2018: 10 · 2017: 8 · 2016: 9 · 2015: 13 · 2014: 11 · 2013: 16 · 2012: 16
- FWCI
- 12.81
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- British Journal of Anaesthesia (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Mayo Clinic
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Airway Management and Intubation Techniques
- Keywords
- obstructive sleep apnea, bariatric surgery, perioperative complications, apnea-hypopnea index, obesity, laparoscopic surgery, open surgery, positive airway pressure, pulmonary complications, body mass index
- MeSH terms
- Adult, Epidemiologic Methods, Female, Humans, Length of Stay, Male, Middle Aged, Postoperative Complications, Preoperative Care, Respiration Disorders, Body Mass Index, Polysomnography, Sleep Apnea, Obstructive, Continuous Positive Airway Pressure, Bariatric Surgery
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