Does Obstructive Sleep Apnea Affect Perioperative Complications? A Retrospective Study Using a Modified NSQIP...

Area of Science:

• Anesthesiology and Perioperative Medicine
• Surgical Outcomes Research
• Sleep Medicine

Background:

• Obstructive sleep apnea (OSA) is a known risk factor for perioperative complications.
• The National Surgical Quality Improvement Project (NSQIP) database historically lacks OSA as a reported comorbidity.
• Understanding OSA's impact on surgical outcomes is crucial for patient safety.

Purpose of the Study:

• To investigate the association between obstructive sleep apnea (OSA) and perioperative complications.
• To integrate OSA status into the NSQIP database for enhanced outcome analysis.
• To compare perioperative outcomes between surgical patients with and without OSA.

Main Methods:

• Retrospective chart review of surgical patients at Lahey Hospital and Medical Center (LHMC) from 2013-2016.
• Inclusion of OSA status in the hospital's NSQIP database.
• Matched comparison of patients with OSA against a control group without OSA, adjusting for key demographic and clinical factors.

Main Results:

• A total of 7872 patients were analyzed, with a 9.4% prevalence of OSA (739 patients).
• No statistically significant differences were observed in 30-day mortality, unplanned intubation, pulmonary embolism, respiratory failure, cardiac arrest, myocardial infarction, surgical site infections, sepsis, or length of stay.
• Matched analysis of 631 patients with OSA versus controls revealed comparable perioperative outcomes.

Conclusions:

• Obstructive sleep apnea (OSA) status was not associated with increased perioperative mortality or complications in this cohort.
• This study represents the first to incorporate OSA status into the NSQIP database for perioperative outcome assessment.
• Further randomized controlled trials are warranted to definitively establish the impact of OSA on surgical outcomes.