Identifying patient who have significant risk factors for postoperative complications can help prevent serious and potentially life-threating events following noncardiac surgery. One of these risk factors, obstructive sleep apnea (OSA), was recently studied in over 1,200 patients undergoing major noncardiac surgery. Many of the patients studied already had major risk factors, such as coronary artery disease, stroke, diabetes, and kidney impairment. None of these patients had a prior diagnosis of OSA. Fully two-thirds of this patient group has moderate sleep apnea and 11.2% had severe sleep apnea.
The statistics surrounding this study group, as it applies to postoperative complications, is eye opening. Patients with severe sleep apnea had a 13 times higher risk of cardiac death, an 80% risk of myocardial injury, and a 6 times higher risk of heart failure. There was also a four (4) times higher risk of developing an abnormal heart rhythm, called atrial fibrillation, which can result in heart failure and stroke. Many of the patients had a reduction in their oxygen levels, especially at night, for the first 3 days following their surgery. Many of these patients needed more aggressive measures to relieve their oxygen problems. Some patients needed to return to the ICU, and some required ventilator support.
Patients are often required to have cardiac studies before undergoing surgeries, even if they have no symptoms. Screening for sleep apnea can begin with a simple home overnight oxygen monitor called a pulse oximeter. Better safe than sorry.
