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30-Day Postoperative Outcomes in Adults with Obstructive Sleep Apnea Undergoing Upper Airway Surgery

Background: Obstructive sleep apnea (OSA) is a chronic disorder of the upper airway. OSA surgery has oftentimes been researched based on the outcomes of single-institutional facilities. We retrospectively analyzed a multi-institutional national database to investigate the outcomes of OSA surgery and...

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Autores principales: Knoedler, Samuel, Knoedler, Leonard, Baecher, Helena, Kauke-Navarro, Martin, Obed, Doha, Hoch, Cosima C., Diehm, Yannick F., Vosler, Peter S., Harréus, Ulrich, Kneser, Ulrich, Panayi, Adriana C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9783895/
https://www.ncbi.nlm.nih.gov/pubmed/36555986
http://dx.doi.org/10.3390/jcm11247371
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author Knoedler, Samuel
Knoedler, Leonard
Baecher, Helena
Kauke-Navarro, Martin
Obed, Doha
Hoch, Cosima C.
Diehm, Yannick F.
Vosler, Peter S.
Harréus, Ulrich
Kneser, Ulrich
Panayi, Adriana C.
author_facet Knoedler, Samuel
Knoedler, Leonard
Baecher, Helena
Kauke-Navarro, Martin
Obed, Doha
Hoch, Cosima C.
Diehm, Yannick F.
Vosler, Peter S.
Harréus, Ulrich
Kneser, Ulrich
Panayi, Adriana C.
author_sort Knoedler, Samuel
collection PubMed
description Background: Obstructive sleep apnea (OSA) is a chronic disorder of the upper airway. OSA surgery has oftentimes been researched based on the outcomes of single-institutional facilities. We retrospectively analyzed a multi-institutional national database to investigate the outcomes of OSA surgery and identify risk factors for complications. Methods: We reviewed the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database (2008–2020) to identify patients who underwent OSA surgery. The postoperative outcomes of interest included 30-day surgical and medical complications, reoperation, readmission, and mortality. Additionally, we assessed risk-associated factors for complications, including comorbidities and preoperative blood values. Results: The study population included 4662 patients. Obesity (n = 2909; 63%) and hypertension (n = 1435; 31%) were the most frequent comorbidities. While two (0.04%) deaths were reported within the 30-day postoperative period, the total complication rate was 6.3% (n = 292). Increased BMI (p = 0.01), male sex (p = 0.03), history of diabetes (p = 0.002), hypertension requiring treatment (p = 0.03), inpatient setting (p < 0.0001), and American Society of Anesthesiology (ASA) physical status classification scores ≥ 4 (p < 0.0001) were identified as risk-associated factors for any postoperative complications. Increased alkaline phosphatase (ALP) was identified as a risk-associated factor for the occurrence of any complications (p = 0.02) and medical complications (p = 0.001). Conclusions: OSA surgery outcomes were analyzed at the national level, with complications shown to depend on AP levels, male gender, extreme BMI, and diabetes mellitus. While OSA surgery has demonstrated an overall positive safety profile, the implementation of these novel risk-associated variables into the perioperative workflow may further enhance patient care.
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spelling pubmed-97838952022-12-24 30-Day Postoperative Outcomes in Adults with Obstructive Sleep Apnea Undergoing Upper Airway Surgery Knoedler, Samuel Knoedler, Leonard Baecher, Helena Kauke-Navarro, Martin Obed, Doha Hoch, Cosima C. Diehm, Yannick F. Vosler, Peter S. Harréus, Ulrich Kneser, Ulrich Panayi, Adriana C. J Clin Med Article Background: Obstructive sleep apnea (OSA) is a chronic disorder of the upper airway. OSA surgery has oftentimes been researched based on the outcomes of single-institutional facilities. We retrospectively analyzed a multi-institutional national database to investigate the outcomes of OSA surgery and identify risk factors for complications. Methods: We reviewed the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database (2008–2020) to identify patients who underwent OSA surgery. The postoperative outcomes of interest included 30-day surgical and medical complications, reoperation, readmission, and mortality. Additionally, we assessed risk-associated factors for complications, including comorbidities and preoperative blood values. Results: The study population included 4662 patients. Obesity (n = 2909; 63%) and hypertension (n = 1435; 31%) were the most frequent comorbidities. While two (0.04%) deaths were reported within the 30-day postoperative period, the total complication rate was 6.3% (n = 292). Increased BMI (p = 0.01), male sex (p = 0.03), history of diabetes (p = 0.002), hypertension requiring treatment (p = 0.03), inpatient setting (p < 0.0001), and American Society of Anesthesiology (ASA) physical status classification scores ≥ 4 (p < 0.0001) were identified as risk-associated factors for any postoperative complications. Increased alkaline phosphatase (ALP) was identified as a risk-associated factor for the occurrence of any complications (p = 0.02) and medical complications (p = 0.001). Conclusions: OSA surgery outcomes were analyzed at the national level, with complications shown to depend on AP levels, male gender, extreme BMI, and diabetes mellitus. While OSA surgery has demonstrated an overall positive safety profile, the implementation of these novel risk-associated variables into the perioperative workflow may further enhance patient care. MDPI 2022-12-12 /pmc/articles/PMC9783895/ /pubmed/36555986 http://dx.doi.org/10.3390/jcm11247371 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Knoedler, Samuel
Knoedler, Leonard
Baecher, Helena
Kauke-Navarro, Martin
Obed, Doha
Hoch, Cosima C.
Diehm, Yannick F.
Vosler, Peter S.
Harréus, Ulrich
Kneser, Ulrich
Panayi, Adriana C.
30-Day Postoperative Outcomes in Adults with Obstructive Sleep Apnea Undergoing Upper Airway Surgery
title 30-Day Postoperative Outcomes in Adults with Obstructive Sleep Apnea Undergoing Upper Airway Surgery
title_full 30-Day Postoperative Outcomes in Adults with Obstructive Sleep Apnea Undergoing Upper Airway Surgery
title_fullStr 30-Day Postoperative Outcomes in Adults with Obstructive Sleep Apnea Undergoing Upper Airway Surgery
title_full_unstemmed 30-Day Postoperative Outcomes in Adults with Obstructive Sleep Apnea Undergoing Upper Airway Surgery
title_short 30-Day Postoperative Outcomes in Adults with Obstructive Sleep Apnea Undergoing Upper Airway Surgery
title_sort 30-day postoperative outcomes in adults with obstructive sleep apnea undergoing upper airway surgery
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9783895/
https://www.ncbi.nlm.nih.gov/pubmed/36555986
http://dx.doi.org/10.3390/jcm11247371
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