Tafelmeier, Maria and Weizenegger, Teresa and Ripfel, Sarah and Fauser, Miriam and Floerchinger, Bernhard and Camboni, Daniele and Zausig, York and Wittmann, Sigrid and Drzymalski, Marzena A. and Zeman, Florian and Schmid, Christof and Maier, Lars S. and Wagner, Stefan and Arzt, Michael (2018) Postoperative complications after elective coronary artery bypass grafting surgery in patients with sleep-disordered breathing. CLINICAL RESEARCH IN CARDIOLOGY, 107 (12). pp. 1148-1159. ISSN 1861-0684, 1861-0692
Full text not available from this repository. (Request a copy)Abstract
BackgroundSleep-disordered breathing (SDB) may increase the risk of postoperative complications in patients after cardiac surgery. This study evaluated the length of hospital stay as well as postoperative cardiac, respiratory, and renal complications after elective coronary artery bypass grafting (CABG) in patients without SDB, with central sleep apnea (CSA), or with obstructive sleep apnea (OSA).MethodsThe presence and type of SDB had been assessed with polygraphic recordings in 100 patients the night before elective CABG surgery. SDB was defined as an apnea-hypopnea index (AHI) of 15/h. Prolonged length of hospital stay (LOS) and postoperative hemodynamic instability due to any cause were retrospectively evaluated as primary endpoints and cardiac, respiratory, and renal complications as secondary endpoints.Results37% of patients had SDB, 14% CSA, and 23% OSA. LOS differed significantly between patients without SDB and those with CSA and OSA [median (25;75. percentile): 8.0days (7.5;11.0) vs. 9.5days (7.0;12.5) vs. 12.0days (9.0;17.0), Kruskal-Wallis test between three groups: p=0.023; OSA vs. no SDB: p=0.005]. AHI was significantly associated with prolonged LOS [>9days; odds ratio (OR) (95% confidence interval): 1.047 (1.001;1.095), p=0.044]. Prolonged need of vasopressors (48h) was observed in 36% of patients without SDB, in 64% with CSA, and in 62% with OSA (p=0.037). AHI was significantly associated with prolonged (48h) need of vasopressors [OR (95% CI): 1.052 (1.002;1.104), p=0.040], independent of any confounders.ConclusionsSDB, particularly OSA, is associated with prolonged LOS after CABG, independent of known confounders. Prolonged LOS in patients with SDB may be due to increased postoperative hemodynamic instability due to any cause.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | LENGTH-OF-STAY; CARDIAC-SURGERY; ATRIAL-FIBRILLATION; HEART-FAILURE; APNEA SYNDROME; FLUID SHIFT; OUTCOMES; ASSOCIATION; PREVALENCE; PRESSURE; Cardiac surgery; Coronary artery bypass grafting; Coronary artery disease; Sleep apnea |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 04 Oct 2019 10:02 |
| Last Modified: | 04 Oct 2019 10:02 |
| URI: | https://pred.uni-regensburg.de/id/eprint/13437 |
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