Perioperative medicine & outcomes
Perioperative adverse events in adult patients with obstructive sleep apnea undergoing ambulatory surgery: An updated systematic review and meta-analysis
Pooled result · Same-day admission, all surgery typesResult — go to the resultOdds ratio 1.94 95% CI 1.46–2.59Authors' conclusion
Ambulatory surgical patients with OSA had almost two-fold higher odds of same-day admission compared to non-OSA patients. Multiple large studies also reported an association of OSA with prolonged PACU LOS, respiratory complications, and/or ICU admission.
Study context
- Population
- Adults undergoing ambulatory surgery under general and/or regional anesthesia
- Participants
- 375,389 adults · 17 studies
- Comparison
- Obstructive sleep apnea (OSA) vs no OSA
- Outcome
- Perioperative adverse events
Methodological detailsrandom effects model, sensitivity analyses
- Random effects model
- Sensitivity analyses
Pooled result
Same-day admission, all surgery types
Odds ratio
1.94
95% CI 1.46–2.59
P < 0.00001
OSA vs non-OSA
OR 1.94 (95% CI 1.46–2.59); P < 0.00001
As reported in the abstract
Further pooled results
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Same-day admission, orthopedic surgery (subgroup)I2:41%; 6 studies, n = 132,473 | 2.68 (2.05–3.48) | P < 0.00001 | |
| 0.20.5125Odds ratio (log scale) |
Prolonged post anesthesia care unit (PACU) length of stay (LOS)
- 3 studies: OSA strongly associated with prolonged PACU LOS; 1 study: not statistically significant
Safety
Postoperative respiratory depression/hypoxia and complications
- 4 studies: OSA associated with postoperative respiratory depression/hypoxia
- 1 large shoulder arthroscopy study: increased odds of pulmonary compromise (almost 5-fold), MI (5-fold), acute renal failure (3-fold), intensive care unit (ICU) admission (5-fold)
Original publication
Perioperative adverse events in adult patients with obstructive sleep apnea undergoing ambulatory surgery: An updated systematic review and meta-analysis. J Clin Anesth. Published 7 May 2024. doi:10.
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