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How Relevant Is Pre-operative Obstructive Sleep Apnoea in the Asymptomatic Bariatric Surgery Patient?

  • Emily O’ReillyEmail author
  • Liam Doherty
  • Colm O’Boyle
Original Contributions
  • 45 Downloads

Abstract

Introduction

The American Academy of Sleep Medicine recommends patients attending for bariatric surgery (BS) to be evaluated for obstructive sleep apnoea (OSA) as untreated OSA is associated with a greater risk of post-operative complications. Not all bariatric patients have symptoms of OSA and their phenotype may be at less risk than the typical sleep clinic phenotype. Therefore, all patients may not require pre-operative sleep studies. This study aimed to establish whether screened and unscreened BS patients are at increased risk of post-operative complications.

Methods

A retrospective review of BS patients at a single centre, June 2008–May 2017. Demographic data, sleep study outcomes, post-operative complications, length of stay (LOS), intensive care unit (ICU) admission, and readmission rates were reviewed.

Results

A total of 510 patients underwent gastric bypass, sleeve gastrectomy, or gastric banding. 385/510 (75.5%) were female. Mean age was 46 ± 11.27 years, mean BMI was 49 kg/m2 ± 7.42. OSA was diagnosed in 300/510 (58.8%) and normal sleep in 57/510 (11.2%). OSA was not associated with increased post-operative complications. No significant difference between screened and unscreened patients for the development of post-operative pulmonary or cardiac complications, (p = 0.607, p = 0.827, respectively). Increasing age was a predictor for pulmonary (p = 0.011) and cardiac (p = 0.018) complications.

Conclusion

OSA is very prevalent in morbidly obese patients. The lack of association between patients diagnosed with OSA and unscreened patients, and post-operative complications suggests that not all patients require pre-operative sleep studies. Further studies may help identify which patients can safely avoid OSA screening.

Keywords

Bariatric surgery Sleep study Sleep medicine Polygraphy Peri-operative BMI Body mass index Post-operative STOP-BANG Epworth sleepiness scale AHI Apnoea-hypopnea index Continuous positive airway pressure Morbid obesity Obstructive sleep apnoea Length of stay Post operative 

Abbreviations

BS

Bariatric surgery

OSA

Obstructive sleep apnoea

LOS

Length of stay

ICU

Intensive care unit

AHI

Apnoea-Hypopnea Index

CPAP

Continuous positive airway pressure

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interest.

Ethics Statement

This study received ethical approval from the regional Clinical Research Ethics Committee and from the institutional Ethics Committee. All procedures were in accordance with the ethical standards of the institutional and regional ethics committee.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Bon Secours HospitalBon Secours Health System CorkIreland
  2. 2.University College Cork CorkIreland

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