The Veterans Affairs Western New York Healthcare System, Western New York, Buffalo, NY 14215-1199, USA; Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY 14260, USA.
The Veterans Affairs Western New York Healthcare System, Western New York, Buffalo, NY 14215-1199, USA; Department of Anesthesiology, University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY 14260, USA.
J Clin Anesth. 2014 Dec;26(8):591-600. doi: 10.1016/j.jclinane.2014.05.010. Epub 2014 Oct 16.
To determine whether a diagnosis of obstructive sleep apnea (OSA) imparts an increased risk of postoperative respiratory failure, cardiac events, and intensive care unit (ICU) transfer than patients with no OSA diagnosis.
Systematic review and meta-analysis.
Academic Veterans Affairs Medical Center.
PubMed, EMBASE, CINAHL, and ISI Web of Knowledge databases were searched through April 2013 for studies that examined the relationship between OSA and postoperative respiratory and cardiac complications among adults. Either fixed or random-effects models were used to calculate the pooled risk estimates. Sensitivity analysis was conducted to examine the robustness of pooled outcomes.
Seventeen studies with a total of 7,162 patients were included. Overall, OSA was associated with significant increase in risk of respiratory failure [odds ratio (OR) 2.42; 95% confidence intervals (CI) 1.53 - 3.84; P = 0.0002] and cardiac events postoperatively (OR = 1.63; 95% CI 1.16 - 2.29; P = 0.005). Heterogeneity was low for these outcomes (I(2) = 5% and 0%, respectively). ICU transfer occurred also more frequently in patients with OSA (OR 2.46; 95% CI 1.29 - 4.68; P = 0.006). These results did not materially change in the sensitivity analyses according to various inclusion criteria.
Surgical patients with OSA are at increased risk of postoperative respiratory failure, cardiac events, and ICU transfer.
确定阻塞性睡眠呼吸暂停（OSA）的诊断是否比没有 OSA 诊断的患者增加术后呼吸衰竭、心脏事件和重症监护病房（ICU）转移的风险。
系统评价和荟萃分析。
学术退伍军人事务医疗中心。
通过 2013 年 4 月在 PubMed、EMBASE、CINAHL 和 ISI Web of Knowledge 数据库中搜索研究，这些研究检查了 OSA 与成年人术后呼吸和心脏并发症之间的关系。使用固定或随机效应模型计算汇总风险估计值。进行敏感性分析以检查汇总结果的稳健性。
共纳入 17 项研究，总计 7162 例患者。总体而言，OSA 与呼吸衰竭的风险显著增加相关[比值比（OR）2.42；95%置信区间（CI）1.53 - 3.84；P = 0.0002]和术后心脏事件（OR = 1.63；95% CI 1.16 - 2.29；P = 0.005）。这些结果的异质性较低（I(2)分别为 5%和 0%）。OSA 患者 ICU 转移的发生率也更高（OR 2.46；95% CI 1.29 - 4.68；P = 0.006）。根据各种纳入标准，敏感性分析结果并未发生实质性变化。
患有 OSA 的手术患者术后呼吸衰竭、心脏事件和 ICU 转移的风险增加。
