Impact of sleep disordered breathing on short-term post-operative outcome after elective coronary artery bypass graft surgery: a prospective observational study

被引:22
作者
Rupprecht, Sven [1 ,2 ]
Schultze, Torsten [1 ]
Nachtmann, Andreas [3 ]
Rastan, Ardawan Julian [4 ]
Doenst, Torsten [5 ]
Schwab, Matthias [1 ]
Witte, Otto W. [1 ]
Rohe, Sebastian [1 ]
Zwacka, Isabelle [1 ]
Hoyer, Heike [6 ]
机构
[1] Jena Univ Hosp, Hans Berger Dept Neurol, Erlanger Allee 101, D-07740 Jena, Germany
[2] Jena Univ Hosp, Ctr Sepsis Control & Care, Jena, Germany
[3] Rotenburg Heart Ctr, Dept Neurol, Rotenburg, Germany
[4] Rotenburg Heart Ctr, Dept Cardiothorac Surg, Rotenburg, Germany
[5] Jena Univ Hosp, Dept Cardiothorac Surg, Jena, Germany
[6] Jena Univ Hosp, Inst Med Stat Informat Sci & Documentat, Jena, Germany
关键词
POSITIVE AIRWAY PRESSURE; APNEA; MORTALITY; RISK; EVENTS; COMPLICATIONS; DYSFUNCTION; ACCURACY;
D O I
10.1183/13993003.01486-2016
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Sleep disordered breathing (SDB) is common in patients with coronary disease, but its impact on post-operative recovery after coronary artery bypass graft surgery (CABG) is unclear. We therefore determined the effects of SDB on post-operative outcome after elective CABG. In this prospective two-centre study, 219 patients due to receive elective CABG underwent cardiorespiratory polygraphy for SDB prior to surgery and were monitored for post-operative complications. The primary end-point was a composite of 30-day mortality or major post-operative complications (cardiac, respiratory, surgical, infectious, acute renal failure or stroke). Key secondary end-points were single components of the primary end-point. SDB was present in 69% and moderate/severe SDB in 43% of the CABG patients. There was no difference in the composite of 30-day mortality or major postoperative complications between patients with and without SDB (OR 0.97, 95% CI 0.49-1.96) and between patients with moderate/severe SDB and no/mild SDB (OR 1.07, 95% CI 0.55-2.06). However, moderate/severe SDB was associated with higher rates of mortality (crude OR 10.1, 95% CI 1.22-83.5), sepsis (OR 2.96, 95% CI 1.17-7.50) and respiratory complications (OR 2.85, 95% CI 1.46-5.55). Although SDB was not associated with higher overall morbidity/mortality, moderate/severe SDB may increase the risk of death, and septic and respiratory complications, after elective CABG.
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页数:10
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