Tafelmeier, Maria and Luft, Lili and Zistler, Elisabeth and Floerchinger, Bernhard and Camboni, Daniele and Creutzenberg, Marcus and Zeman, Florian and Schmid, Christof and Maier, Lars Siegfried and Wagner, Stefan and Arzt, Michael (2021) Central Sleep Apnea Predicts Pulmonary Complications After Cardiac Surgery. CHEST, 159 (2). pp. 798-809. ISSN 0012-3692, 1931-3543
Full text not available from this repository. (Request a copy)Abstract
BACKGROUND: Postoperative major pulmonary complications (MPCs) continue to be leading causes of increased morbidity and death after cardiac surgery. Although various risk factors have been identified, reports on the association between sleep-disordered breathing (SDB) and postoperative MPCs remain inconclusive. RESEARCH QUESTION: What is the incidence of the composite end point postoperative MPCs? What are predictors for postoperative MPCs in patients without SDB, with OSA, and with central sleep apnea (CSA) who undergo cardiac surgery? STUDY DESIGN AND METHODS: In this subanalysis of the ongoing prospective observational study "Impact of Sleep-disordered breathing on Atrial Fibrillation and Perioperative complications in Patients undergoing Coronary Artery Bypass grafting Surgery (CONSIDER AF)," preoperative risk factors for postoperative MPCs were examined in 250 patients who underwent cardiac surgery. PostoperativeMPCs (including respiratory failure, acute respiratory distress syndrome, pneumonia, or pulmonary embolism) were registered prospectively within the first seven postoperative days. Presence and type of SDB were assessed the night prior to surgery with the use of portable SDB-monitoring. RESULTS: Patients with SDB experienced significantly more often postoperative MPCs than patients without SDB (24% vs 7%; P <.001). Multivariable logistic regression analysis showed that CSA (OR, 4.68 [95% CI, 1.78-12.26]; P =.002), heart failure (OR, 2.65 [95% CI, 1.11-6.31]; P =.028), and a history of transient ischemic attack or stroke (OR, 2.73 [95% CI, 1.07-6.94]; P =.035) were associated significantly with postoperative MPCs. Compared with patients without MPCs, those with postoperative MPCs had a significantly longer hospital stay (median days, 9 [25th/75th percentile, 7/13] vs 19 [25th/75th percentile, 11/38]; P <.001). INTERPRETATION: Among established risk factors for postoperative MPCs, CSA, heart failure, and history of transient ischemic attack or stroke were associated significantly with postoperative MPCs. Our findings contribute to the identification of patients who are at high-risk for postoperative MPCs.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ; CABG; coronary artery; coronary artery bypass grafting; postoperative complication; sleep apnea |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie Medicine > Lehrstuhl für Innere Medizin II Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Klinische Studien |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 12 Jul 2022 06:02 |
| Last Modified: | 12 Jul 2022 06:02 |
| URI: | https://pred.uni-regensburg.de/id/eprint/45701 |
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