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Postoperative complications after elective coronary artery bypass grafting surgery in patients with sleep-disordered

Maria Tafelmeier1, Teresa Weizenegger2, Sarah Ripfel2

  • 1Department of Internal Medicine II (Cardiology, Pneumology, and Intensive Care), University Medical Centre Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany. maria.tafelmeier@ukr.de.

Clinical Research in Cardiology : Official Journal of the German Cardiac Society
|June 27, 2018
PubMed

Insights

Sleep-disordered breathing (SDB), especially obstructive sleep apnea (OSA), significantly prolongs hospital stays after coronary artery bypass grafting (CABG). This increased length of stay is linked to greater postoperative hemodynamic instability.

Area of Science:

  • Cardiology
  • Sleep Medicine
  • Anesthesiology

Background:

  • Sleep-disordered breathing (SDB) is a potential risk factor for complications following cardiac surgery.
  • Understanding the impact of SDB subtypes, central sleep apnea (CSA) and obstructive sleep apnea (OSA), on postoperative outcomes is crucial.

Purpose of the Study:

  • To evaluate the association between SDB and length of hospital stay (LOS) after elective coronary artery bypass grafting (CABG).
  • To assess the impact of SDB on postoperative cardiac, respiratory, and renal complications.
  • To determine if SDB influences postoperative hemodynamic instability.

Main Methods:

  • Polygraphic recordings assessed SDB presence and type (CSA, OSA) in 100 patients pre-CABG.
  • SDB defined by apnea-hypopnea index (AHI) ≥ 15/h.
  • Retrospective analysis of prolonged LOS, hemodynamic instability, and other complications.

Main Results:

  • 37% of patients had SDB (14% CSA, 23% OSA).
  • Patients with OSA had significantly longer LOS compared to those without SDB (p=0.005).
  • Higher AHI correlated with prolonged LOS (OR 1.047, p=0.044) and need for vasopressors (OR 1.052, p=0.040).

Conclusions:

  • Obstructive sleep apnea (OSA) is independently associated with prolonged LOS post-CABG.
  • Increased postoperative hemodynamic instability may contribute to longer hospital stays in SDB patients.
  • SDB management should be considered in cardiac surgery patients to optimize recovery.
Abstract

Keywords:
Cardiac surgeryCoronary artery bypass graftingCoronary artery diseaseSleep apnea

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