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阻塞性睡眠呼吸暂停对冠状动脉旁路移植术患者术后结局的影响:系统评价和荟萃分析。

Impact of obstructive sleep apnoea on postoperative outcomes of patients undergoing coronary artery bypass grafting: a systematic review and meta-analysis.

机构信息

Respiratory medicine, Zhejiang Xinda Hospital, Huzhou, China.

Department of Anesthesiology, Zhejiang Xinda Hospital, 288 Xinguang Ave., 313000, Huzhou, Zhejiang Province, China.

出版信息

Sleep Breath. 2024 Dec;28(6):2345-2353. doi: 10.1007/s11325-024-03154-6. Epub 2024 Sep 6.

Abstract

OBJECTIVE

To assess the association between obstructive sleep apnoea (OSA) and postoperative complications in patients after coronary artery bypass graft (CABG).

METHODS

PubMed, Embase, Web of Science and Scopus databases were explored to identify relevant observational studies that reported incidences of OSA in CABG patients, and assessed OSA using standard objective methods such as polysomnography (PSG). The primary outcomes of interest were risk of major adverse cardiac and cerebrovascular events (MACCE) and all-cause mortality. Pooled effect sizes were reported as odds ratio (OR) with 95% confidence intervals.

RESULTS

Twelve studies were included. All studies, except one, had a prospective cohort design. CABG patients with OSA had increased risk of MACCE (OR 1.71, 95% CI: 1.16, 2.53), myocardial infarction (MI) (OR 2.21, 95% CI: 1.19, 4.13), pulmonary complications (OR 1.86, 95% CI: 1.03, 3.38), renal complications (OR 8.14, 95% CI: 2.07, 32.1), heart failure (OR 1.86, 95% CI: 1.19, 2.89) and need for revascularization (OR 2.80, 95% CI: 1.01, 7.75). However, risk of all-cause mortality (OR 1.63, 95% CI: 0.75, 3.52) was comparable in all patients.

CONCLUSION

This study showed that OSA significantly correlates with the increased risk of major adverse events. Our results indicate that recognizing and managing OSA in CABG patients is crucial for mitigating associated risks.

摘要

目的

评估阻塞性睡眠呼吸暂停(OSA)与冠状动脉旁路移植术(CABG)后患者术后并发症的关系。

方法

检索 PubMed、Embase、Web of Science 和 Scopus 数据库,以确定报告 CABG 患者 OSA 发生率的观察性研究,并使用多导睡眠图(PSG)等标准客观方法评估 OSA。主要观察终点为主要不良心脑血管事件(MACCE)和全因死亡率的风险。汇总效应大小以比值比(OR)和 95%置信区间(CI)报告。

结果

共纳入 12 项研究。除了一项研究外,所有研究均采用前瞻性队列设计。患有 OSA 的 CABG 患者发生 MACCE(OR 1.71,95%CI:1.16,2.53)、心肌梗死(MI)(OR 2.21,95%CI:1.19,4.13)、肺部并发症(OR 1.86,95%CI:1.03,3.38)、肾脏并发症(OR 8.14,95%CI:2.07,32.1)、心力衰竭(OR 1.86,95%CI:1.19,2.89)和需要血运重建(OR 2.80,95%CI:1.01,7.75)的风险增加,但所有患者的全因死亡率(OR 1.63,95%CI:0.75,3.52)风险无差异。

结论

本研究表明 OSA 与重大不良事件风险增加显著相关。我们的结果表明,识别和治疗 CABG 患者的 OSA 对于降低相关风险至关重要。

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