PURPOSE:Obstructive Sleep Apnea (OSA) is a common medical condition with serious cardiovascular implications. Purpose of this study is to evaluate the impact of undetected OSA on post operative period after Coronary Artery Bypass Surgery (CABG).
METHODS:A total of 118 consequetive patients undergoing CABG were screened with Berlin Questionnaire. The Berlin Questionnaire has three components, and those scoring high on at least two sections are considered at risk for OSA. Both high risk and low risk patients were monitored for various adverse consequences 30 days post-operatively.
RESULTS:Patients who were in high risk category for OSA spent a mean of 3.15 days in Intensive care unit (ICU) as compared to 2.56 days spent by patients in low risk category (P value= .01). Patients who spent more than 24 hours on mechanical ventilator spent mean of 85 hours on ventilator (high risk for OSA) compared to 50 hours (low risk for OSA) (P value=.03). Patients in high risk category for OSA spent a mean of 9.91 days in hospital compared to 8.28 days in low risk category (P value=.01). Hospital readmission rate was 14% (high risk) vs 10% (low risk). Re-intubation/respiratory failure rate was higher in high risk category 10% (8/79) in high risk category Vs 2.56% (1/39) in low risk category, though it did not reach statistical significance. No significant differences were noted in rates of Pulmonary Edema, arrythmias, and wound infections. New onset atrial fibrillation appeared to be higher in low risk category (23%) Vs high risk category (16%) (P value =.23) (NS).
CONCLUSION:Patient population with high risk for OSA undergoing CABG surgery spend more time on ventilator, ICU and had increased hospital length of stay. High risk patients also show a trend towards more respiratory failure/re-intubations during post-operative period.
CLINICAL IMPLICATIONS:Early diagnosis of patients who are high risk for having OSA and undergoing CABG surgery may help reduce, time spent on ventilator and length of stay in ICU/hospital.
DISCLOSURE:Sunil Sharma, No Financial Disclosure Information; No Product/Research Disclosure Information