Department of Surgery, Division of General Surgery, Lahey Hospital and Medical Center, 41 Mall Road, Burlington, MA, 01805, USA.
World J Surg. 2020 Aug;44(8):2609-2613. doi: 10.1007/s00268-020-05533-y.
Obstructive sleep apnea (OSA) has been linked to increased perioperative complications. The National Surgical Quality Improvement Project (NSQIP), which is the leading outcomes-based patient database, does not report OSA as a comorbidity. Therefore, we started recording the patient's OSA status as part of Lahey Hospital and Medical Center's (LHMC) NSQIP database in an effort to study the effect of OSA on perioperative complications.
Starting July 2013 we have been including patients' OSA status in our hospital's NSQIP database. We conducted chart review of all patients who underwent any surgical intervention at LHMC between 2013 and 2016 and identified those who had OSA as part of their medical history. We then compared their perioperative mortality and complications to a matched sample.
A total of 7872 patients were examined. In total, 739 patients had OSA bringing our prevalence to 9.4%. In total, 631 were matched to patients without OSA after adjusting for age, gender, BMI and multiple other comorbidities. We found no statistically significant difference in 30-day mortality (0.1 vs 0%), unplanned intubation (2.6 vs 1.1%), pulmonary embolism (0.5 vs 0.2%), respiratory failure requiring mechanical ventilation (2.3 vs 1.4%), cardiac arrest (0.5 vs 0.3%), myocardial infarction (0.4 vs 0.5%), surgical site infections (4.6 vs 4.3%), sepsis (2.4 vs 1.9%) and average length of stay (3.8 vs 4.2).
Patients with OSA did not have any statistically significant difference in post-op complications or mortality when compared to patients without OSA. This is the first study that tracked OSA status as part of the NSQIP database and studied its effect on perioperative complications. Randomized controlled studies are needed to conclude whether OSA status affects perioperative outcomes.
阻塞性睡眠呼吸暂停（OSA）与围手术期并发症的增加有关。美国国家手术质量改进计划（NSQIP）是领先的基于结果的患者数据库，但并未将 OSA 报告为合并症。因此，我们开始将患者的 OSA 状态记录为莱希医院和医疗中心（LHMC）NSQIP 数据库的一部分，以研究 OSA 对围手术期并发症的影响。
从 2013 年 7 月开始，我们一直在将患者的 OSA 状态纳入我们医院的 NSQIP 数据库。我们对 2013 年至 2016 年期间在 LHMC 接受任何手术干预的所有患者进行了病历回顾，并确定了那些 OSA 作为其病史一部分的患者。然后，我们将他们的围手术期死亡率和并发症与匹配的样本进行了比较。
共检查了 7872 例患者。共有 739 例患者患有 OSA，患病率为 9.4%。总共 631 例与没有 OSA 的患者匹配，调整了年龄、性别、BMI 和其他多种合并症。我们发现 30 天死亡率（0.1%对 0%）、计划外插管（2.6%对 1.1%）、肺栓塞（0.5%对 0.2%）、需要机械通气的呼吸衰竭（2.3%对 1.4%）、心搏骤停（0.5%对 0.3%）、心肌梗死（0.4%对 0.5%）、手术部位感染（4.6%对 4.3%）、败血症（2.4%对 1.9%）和平均住院时间（3.8 对 4.2）无统计学显著差异。
与没有 OSA 的患者相比，患有 OSA 的患者在术后并发症或死亡率方面没有任何统计学显著差异。这是第一项将 OSA 状态作为 NSQIP 数据库的一部分进行跟踪并研究其对围手术期并发症影响的研究。需要进行随机对照研究来确定 OSA 状态是否影响围手术期结局。
