Association between obstructive sleep apnea and atrial fibrillation and delirium after cardiac surgery. Sub-analysis of DECADE trial

Rivas, E; Shehata, P; Bravo, M; Almonacid-Cardenas, F; Shah, K; Kopac, O; Ruetzler, K; Troianos, CA; Turan, A

doi:10.1016/j.jclinane.2023.111109

Cardiothoracic & vascular anesthesia

Association between obstructive sleep apnea and atrial fibrillation and delirium after cardiac surgery. Sub-analysis of DECADE trial

J Clin AnesthPublished 21 Mar 2023Secondary analysis of the DECADE randomised trial

Primary resultResultOdds ratio 1.22 95% CI 0.75,1.99

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Authors' conclusion

In adult patients having cardiac surgery, OSA is not associated with a higher incidence of postoperative atrial fibrillation and delirium.

Study context

Population: Adults having cardiac surgery, Cleveland Clinic hospitalsincluded in final analysis
Participants: 590 adults

Comparison: Obstructive Sleep Apnea (OSA) vs no OSA
OSAn = 133
non-OSAn = 457reference
Primary endpoint: Atrial fibrillation (clinician diagnosis or documented arrhythmia)

Methodological detailsinverse probability of treatment weighting

Inverse probability of treatment weighting

Primary result

As reported in the abstract

Odds ratio

1.22

95% CI 0.75,1.99

P = 0.416

Events by treatment group

OSA37%49 of 133

non-OSA33%150 of 457

OSA vs non-OSA

OR 1.22 (95% CI 0.75,1.99); P = 0.416

Secondary outcomes

Outcome	OSA	non-OSA		OR (95% CI)	P value
Delirium (CAM-ICU, twice in first 5 postoperative days)	17%	15%	0.512	0.93 (0.51,1.69)	P = 0.800
			0.512Odds ratio (log scale)

Original publication

Association between obstructive sleep apnea and atrial fibrillation and delirium after cardiac surgery. Sub-analysis of DECADE trial. J Clin Anesth. Published 21 March 2023. doi:10.1016/j.jclinane.2023.111109

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