Seet, Edwin and Waseem, Rida and Chan, Matthew T. and Wang, Chew Yin and Liao, Vanessa and Suen, Colin and Chung, Frances (2022) Characteristics of patients with unrecognized sleep apnea requiring postoperative oxygen therapy. Journal of Personalized Medicine, 12 (10). ISSN 2075-4426, DOI https://doi.org/10.3390/jpm12101543.
Full text not available from this repository.Abstract
Surgical patients with obstructive sleep apnea (OSA) have increased risk of perioperative complications. The primary objective is to determine the characteristics of surgical patients with unrecognized OSA requiring oxygen therapy for postoperative hypoxemia. The secondary objective is to investigate the characteristics of patients who were responsive to oxygen therapy. This was a post-hoc multicenter study involving patients with cardiovascular risk factors undergoing major non-cardiac surgery. Patients >= 45 years old underwent Type 3 sleep apnea testing and nocturnal oximetry preoperatively. Responders to oxygen therapy were defined as individuals with >= 50% reduction in oxygen desaturation index (ODI) on postoperative night 1 versus preoperative ODI. In total, 624 out of 823 patients with unrecognized OSA required oxygen therapy. These were mostly males, had larger neck circumferences, higher Revised Cardiac Risk Indices, higher STOP-Bang scores, and higher ASA physical status, undergoing intraperitoneal or vascular surgery. Multivariable regression analysis showed that the preoperative longer cumulative time SpO(2) < 90% or CT90% (adjusted p = 0.03), and lower average overnight SpO(2) (adjusted p < 0.001), were independently associated with patients requiring oxygen therapy. Seventy percent of patients were responders to oxygen therapy with >= 50% ODI reduction. Preoperative ODI (19.0 +/- 12.9 vs. 14.1 +/- 11.4 events/h, p < 0.001), CT90% (42.3 +/- 66.2 vs. 31.1 +/- 57.0 min, p = 0.038), and CT80% (7.1 +/- 22.6 vs. 3.6 +/- 8.7 min, p = 0.007) were significantly higher in the responder than the non-responder. Patients with unrecognized OSA requiring postoperative oxygen therapy were males with larger neck circumferences and higher STOP-Bang scores. Those responding to oxygen therapy were likely to have severe OSA and worse preoperative nocturnal hypoxemia. Preoperative overnight oximetry parameters may help in stratifying patients.
| Item Type: | Article |
|---|---|
| Funders: | University Health Network Foundation, ResMed Foundation, Health and Medical Research Fund, Hong Kong [09100351], National Healthcare Group Small Innovative Grant [12019] [15201] |
| Uncontrolled Keywords: | Oxygen therapy; Obstructive sleep apnea; Personalized medicine; Hypoxemia; Postoperative care; Oximetry parameters; phenotypes |
| Subjects: | R Medicine |
| Divisions: | Faculty of Medicine |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 26 Sep 2023 03:15 |
| Last Modified: | 26 Sep 2023 03:15 |
| URI: | http://eprints.um.edu.my/id/eprint/40865 |
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