Ng, Ka Ting and Lee, Zong Xuan and Ang, Eshen and Teoh, Wan Yi and Wang, Chew Yin (2020) Association of obstructive sleep apnea and postoperative cardiac complications: A systematic review and meta-analysis with trial sequential analysis. Journal of Clinical Anesthesia, 62. ISSN 0952-8180, DOI https://doi.org/10.1016/j.jclinane.2020.109731.
Full text not available from this repository.Abstract
Objectives: The repetitive hypoxic and hypercapnia events of obstructive sleep apnea (OSA) are believed to adversely affect cardiopulmonary function, which make them vulnerable to a higher incidence of postoperative complications. The primary aim of this systematic review and meta-analysis was to examine the association of OSA and the composite endpoints of postoperative cardiac or cerebrovascular complications in adult undergoing non-cardiac surgery. Data sources: MEDLINE, EMBASE and CENTRAL were systematically searched from its inception until May 2019. Review methods: All observational studies were included. Results: Twenty-two studies (n = 3,033,814; 184,968 OSA vs 2,848,846 non-OSA) were included for quantitative meta-analysis. In non-cardiac surgery, OSA was significantly associated with a higher incidence of the composite endpoints of postoperative cardiac or cerebrovascular complications (odd ratio: 1.44, 95%CI: 1.17 to 1.78, rho = 0.007, trial sequential analysis= conclusive; certainty of evidence = very low). In comparison to nonOSA, OSA patients were reported to have nearly 2.5-fold risk of developing pulmonary complications (odd ratio: 2.52, 95%CI: 1.92 to 3.31,. < 0.001, certainty of evidence = very low), postoperative delirium (odd ratio: 2.45, 95%CI: 1.50 to 4.01,. < 0.001, certainty of evidence = low) and acute kidney injury (odd ratio: 2.41, 95%CI: 1.93 to 3.02,. < 0.001, certainty of evidence = very low). Conclusions: This meta-analysis of 22 comparative studies demonstrated that OSA is a potential risk factor to postoperative adverse complications in adults undergoing non-cardiac surgery. However, the conclusions need to be interpreted with caution due to the nature of included observational studies with significant heterogeneity and low quality of evidence.
| Item Type: | Article |
|---|---|
| Funders: | None |
| Uncontrolled Keywords: | Cardiac complications; Meta-analysis; Mortality; Obstructive sleep apnea; Oximetry Sleep study |
| Subjects: | R Medicine > R Medicine (General) |
| Divisions: | Faculty of Medicine > Anaesthesiology Department |
| Depositing User: | Ms Zaharah Ramly |
| Date Deposited: | 04 Nov 2024 02:09 |
| Last Modified: | 04 Nov 2024 02:09 |
| URI: | http://eprints.um.edu.my/id/eprint/36666 |
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