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Obesity Surgery

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01-11-2013 | Original Contributions

Sleep-Disordered Breathing and Postoperative Outcomes After Bariatric Surgery: Analysis of the Nationwide Inpatient Sample

Authors: Babak Mokhlesi, Margaret D. Hovda, Benjamin Vekhter, Vineet M. Arora, Frances Chung, David O. Meltzer

Published in: Obesity Surgery | Issue 11/2013

Abstract

Background

Sleep-disordered breathing (SDB), also known as obstructive sleep apnea (OSA), has been increasingly recognized as a possible risk factor for adverse perioperative outcomes in non-bariatric surgeries. However, the impact of SDB on postoperative outcomes in patients undergoing bariatric surgery remains less clearly defined. We hypothesized that SDB would be independently associated with worse postoperative outcomes.

Methods

Data were obtained from the Nationwide Inpatient Sample database and included a total of 91,028 adult patients undergoing bariatric surgeries from 2004 to 2008. The primary outcomes were in-hospital death, total charges, and length of stay. There were two secondary outcomes of interest: respiratory and cardiac complications. Regression models were fitted to assess the independent association between SDB and the outcomes of interest.

Results

SDB was independently associated with decreased mortality (OR = 0.34, 95% CI = 0.23–0.50, p < 0.001), total charges (−$869, p < 0.001), and length of stay (−0.25 days, p < 0.001). SDB was independently associated with significantly increased odds ratio of emergent endotracheal intubation (OR = 4.35, 95% CI = 3.97–4.77, p < 0.001), noninvasive ventilation (OR = 14.12, 95% CI = 12.09–16.51, p < 0.001), and atrial fibrillation (OR = 1.25, 95% CI = 1.11–1.41, p < 0.001). Emergent intubation occurred significantly earlier in the postoperative course in patients with SDB. Although non-SDB patients had an overall lower risk of emergent intubation compared to SDB patients, their outcomes were significantly worse when they did get emergently intubated.

Conclusions

In this large nationally representative sample, despite the increased association of SDB/OSA with postoperative cardiopulmonary complications, the diagnosis of SDB/OSA was negatively, rather than positively, associated with in-hospital mortality and resource use.

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Title: Sleep-Disordered Breathing and Postoperative Outcomes After Bariatric Surgery: Analysis of the Nationwide Inpatient Sample
Authors: Babak Mokhlesi
Margaret D. Hovda
Benjamin Vekhter
Vineet M. Arora
Frances Chung
David O. Meltzer
Publication date: 01-11-2013
Publisher: Springer US
Published in: Obesity Surgery / Issue 11/2013
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-013-0991-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Sleep-Disordered Breathing and Postoperative Outcomes After Bariatric Surgery: Analysis of the Nationwide Inpatient Sample

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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