Obstructive Sleep Apnea Should be Evaluated in Those Undergoing Coronary Artery Bypass Graft

Obstructive sleep apnea (OSA) was common in patients undergoing coronary artery bypass graft (CABG) and resulted in postoperative complications, according to research being presented at the CHEST Annual Meeting 2019.

The prospective cohort study included 103 patients who were referred for pulmonary preoperative evaluation and were undergoing CABG between August 2018 and December 2018. Patients self-administered the STOP Bang questionnaire prior to CABG to determine OSA risk; researchers then assessed postoperative complications.

In this cohort, 32 patients (31.07%) were at low risk for OSA, 52 (50.48%) were at intermediate risk, and 19 (18.55%) were at high risk—resulting in a combined 71.83% of patients who were at intermediate to high risk for OSA. The following factors were comparable between those at intermediate to high versus low OSA risk: age, sex, comorbidities (i.e., hypertension, diabetes, dyslipidemia, and previous acute coronary syndrome), and ejection fraction. However, risk of OSA differed when considering body mass index (BMI) and former smoking status.

In this cohort, 24 patients developed postoperative complications, 13 (54.17%) of whom were at high risk for OSA. The most common complications included prolonged intensive care unit stay, postoperative use of non-invasive ventilation, and prolonged intubation.

“Screening patients who will undergo CABG, especially those with [a] BMI >35 kg/m2 and those who are currently smoking or at least smoked in the past eight weeks, is beneficial, as this may help prevent perioperative and postoperative complications,” according to the authors. They noted that the STOP Bang questionnaire can be “advantageous to minimize postoperative risk.”

Reference

  1. Bispo KA, Limpin MA. Association of OSA risk with post-operative complications among coronary artery bypass graft (CABG) patients. Presented at the CHEST Annual Meeting 2019. October 19-23, 2019; New Orleans, Louisiana.