High risk for obstructive sleep apnea hypopnea syndrome predicts new onset atrial fibrillation after cardiac surgery: a retrospective analysis

Title

High risk for obstructive sleep apnea hypopnea syndrome predicts new onset atrial fibrillation after cardiac surgery: a retrospective analysis

Creator

Patel S V; Gill H; Shahi D; Rajabalan A; Patel P; Sonani R; Bhatt P; Rodriguez R D; Bautista M; Deshmukh A; Gonzalez J V; Patel S

Publisher

Sleep and Breathing

Date

2018
2018-12

Description

Purpose Obstructive sleep apnea hypopnea syndrome (OSAHS) is highly prevalent in patients undergoing coronary artery bypass surgery (CABG). OSAHS is a risk factor for the development of atrial fibrillation (AF), but the risk of AF in patients who are high risk for OSAHS is unclear. Methods A retrospective study was conducted on consecutive patients undergoing CABG from 2013 to 2015 without AF pre-operatively. Patients were categorized as low risk for OSAHS, high risk for OSAHS, or diagnosed OSAHS based on medical records review. All diagnosed OSAHS patients were on active treatment with positive airway pressure. Outcomes assessed were postoperative AF (POAF), postoperative length of stay, re-intubation, in-hospital mortality, and cost of hospitalization. Results Out of 209 eligible patients, 66.5% were low-risk for OSAHS, 18.7% high-risk for OSAHS, and 14.8% diagnosed/treated for OSAHS. POAF developed in 96 patients (45.9%) with greater frequency in high-risk OSAHS patients (69.2% high risk, 41.9% low risk, 40.3% diagnosed/treated, p = 0.01). In analyses adjusted for age, sex, ethnicity and comorbidities, high risk for OSAHS was associated with 2.9 greater odds (95% CI [1.2, 7.3], p = 0.02) for POAF while diagnosed/treated OSAHS was not associated with elevated risk (OR = 1.4, 95% CI [0.6, 3.6], p = 0.50) compared to patients at low risk for OSAHS. Conclusions High risk for OSAHS is an independent predictor for POAF in patients undergoing CABG. In contrast, patients diagnosed and treated for their OSAHS are not at elevated risk of POAF. These findings support evaluation of a standardized OSAHS screening and treatment program as part of the pre-operative evaluation for elective CABG.

Subject

arrhythmias; Atrial fibrillation; c-reactive protein; Coronary artery bypass graft surgery; cost; Length of; mortality; Neurosciences & Neurology; outcomes; recurrence; Respiratory System; Screening; Sleep apnea; stay

Format

Journal Article

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Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Pages

1117-1124

Issue

4

Volume

22

Citation

Patel S V; Gill H; Shahi D; Rajabalan A; Patel P; Sonani R; Bhatt P; Rodriguez R D; Bautista M; Deshmukh A; Gonzalez J V; Patel S, “High risk for obstructive sleep apnea hypopnea syndrome predicts new onset atrial fibrillation after cardiac surgery: a retrospective analysis,” NEOMED Bibliography Database, accessed January 26, 2021, https://neomed.omeka.net/items/show/6728.

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