Postoperative Complications in Patients with Unrecognized Obesity Hypoventilation Syndrome Undergoing Elective Non-cardiac Surgery
Cast your vote
You can rate an item by clicking the amount of stars they wish to award to this item.
When enough users have cast their vote on this item, the average rating will also be shown.
Your vote was cast
Thank you for your feedback
Thank you for your feedback
Paz y Mar, Hugo
Hernández, Adrian V.
Aboussouan, Loutfi S.
MetadataShow full item record
PublisherAmerican College of Chest Physicians
JournalChest Journal (Chest)
AbstractBACKGROUND: Among patients with obstructive sleep apnea (OSA) a higher number of medical morbidities are known to be associated with those that have obesity hypoventilation syndrome (OHS) compared to OSA alone. OHS can therefore pose a higher risk of postoperative complications after elective non-cardiac surgery (NCS) and is often unrecognized at the time of surgery. The objective of this study was to retrospectively identify patients with OHS and compare their postoperative outcomes with those who have OSA alone. METHODS: Patients meeting criteria for OHS were identified within a large cohort of patients with OSA who underwent elective NCS at a major tertiary care center. We identified postoperative outcomes associated with OSA and OHS as well as the clinical determinants of OHS (BMI, AHI). Multivariable logistic or linear regression models were used for dichotomous or continuous outcomes, respectively. RESULTS: Patients with hypercapnia from definite or possible OHS, and overlap syndrome are more likely to develop postoperative respiratory failure [OR: 10.9 (95% CI 3.7-32.3), p<0.0001], postoperative heart failure (p<0.0001), prolonged intubation [OR: 5.4 (95% CI 1.9-15.7), p=0.002), postoperative ICU transfer (OR: 3.8 (95% CI 1.7-8.6), p=0.002]; longer ICU (beta coefficient: 0.86; SE: 0.32, p=0.009) and hospital length of stay (beta coefficient: 2.94; SE: 0.87, p=0.0008) when compared to patients with OSA. Among the clinical determinants of OHS, neither BMI nor AHI showed associations with any postoperative outcomes in univariable or multivariable regression. CONCLUSIONS: Better emphasis is needed on preoperative recognition of hypercapnia among patients with OSA or overlap syndrome undergoing elective NCS
- Obesity hypoventilation syndrome, sleep apnea, overlap syndrome: perioperative management to prevent complications.
- Authors: Raveendran R, Wong J, Singh M, Wong DT, Chung F
- Issue date: 2017 Feb
- Obesity hypoventilation syndrome: prevalence and predictors in patients with obstructive sleep apnea.
- Authors: Mokhlesi B, Tulaimat A, Faibussowitsch I, Wang Y, Evans AT
- Issue date: 2007 Jun
- Clinical predictors of obesity hypoventilation syndrome in obese subjects with obstructive sleep apnea.
- Authors: Bingol Z, Pıhtılı A, Cagatay P, Okumus G, Kıyan E
- Issue date: 2015 May
- Comparison of clinical characteristics in patients with obesity hypoventilation syndrome and obese obstructive sleep apnea syndrome: a case-control study.
- Authors: Basoglu OK, Tasbakan MS
- Issue date: 2014 Apr
- Symptomless Multi-Variable Apnea Prediction Index Assesses Obstructive Sleep Apnea Risk and Adverse Outcomes in Elective Surgery.
- Authors: Lyons MM, Keenan BT, Li J, Khan T, Elkassabany N, Walsh CM, Williams NN, Pack AI, Gurubhagavatula I
- Issue date: 2017 Mar 1