Perioperative medicine & outcomes
The effectiveness of positive airway pressure therapy in reducing postoperative adverse outcomes in surgical patients with obstructive sleep apnea: A systematic review and meta-analysis
Pooled result · Postoperative respiratory complications, non-cardiac surgeryResult — go to the resultRelative risk 0.72 95% CI 0.51–1.00Authors' conclusion
In patients with OSA undergoing non-cardiac surgery, PAP therapy was associated with a 28% reduction in the risk of postoperative respiratory complications and 56% reduction in unplanned ICU admission. In patients with OSA undergoing cardiac surgery, PAP therapy decreased the risk of postoperative cardiac complications and atrial fibrillation by 37% and 41%, respectively.
Study context
- Population
- Adults with obstructive sleep apnea (OSA) undergoing surgery (non-cardiac or cardiac)27 studies
- Comparison
- Positive airway pressure (PAP) therapy vs no preoperative and/or postoperative PAP
- Outcome
- Postoperative complications
Methodological detailsMedline and other databases searched from inception to October 17, 2021, 30,514 OSA patients non-cardiac surgery; 837 OSA patients cardiac surgery
- Medline and other databases searched from inception to October 17, 2021
- 30,514 OSA patients non-cardiac surgery; 837 OSA patients cardiac surgery
Pooled result
As reported in the abstract
Postoperative respiratory complications, non-cardiac surgery
Relative risk
0.72
95% CI 0.51–1.00
asymptotic P = 0.05
By group
PAP vs Control
RR 0.72 (95% CI 0.51–1.00); asymptotic P = 0.05
Further pooled results
| Outcome | PAP | Control | RR (95% CI) | P value | |
|---|---|---|---|---|---|
| Unplanned ICU admission, non-cardiac surgery | 0.12% | 4.1% | 0.44 (0.19–0.99) | asymptotic P = 0.05 | |
| All-cause complications, non-cardiac surgery | 11.6% | 14.4% | 0.89 (0.74–1.06) | P = 0.18 | |
| Postoperative cardiac complications, cardiac surgery | 33.7% | 50% | 0.63 (0.51–0.77) | P < 0.0001 | |
| Postoperative AF, cardiac surgery | 40.1% | 66.7% | 0.59 (0.45–0.77) | P < 0.0001 | |
| 0.20.5125Relative risk (log scale) |
Cardiac and neurological complications, hospital LOS, in-hospital mortality, non-cardiac surgery
- No significant differences between the two groups
Original publication
The effectiveness of positive airway pressure therapy in reducing postoperative adverse outcomes in surgical patients with obstructive sleep apnea: A systematic review and meta-analysis. J Clin Anesth. Published 5 November 2022. doi:10.
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