MSpace - DSpace at UofM >
Faculty of Graduate Studies (Electronic Theses and Dissertations) >
FGS - Electronic Theses & Dissertations (Public) >

Please use this identifier to cite or link to this item: http://hdl.handle.net/1993/8114

Title: Serious postoperative cardiovascular and respiratory complications in obstructive sleep apnea patients: matched cohort analysis of clinical and administrative data
Authors: Mutter, Thomas Charles
Supervisor: Roos, Leslie (Community Health Sciences)
Examining Committee: Moffatt, Michael (Community Health Sciences) Ramsey, Clare (Community Health Sciences) Kryger, Meir (Yale University)
Graduation Date: October 2012
Keywords: surgery
anesthesia
complications
arrest
cardiac
Issue Date: 23-Jul-2012
Abstract: Problem: The risk of serious postoperative cardiovascular and respiratory complications (SPCRCs) in patients with obstructive sleep apnea (OSA) is poorly defined. Methods: In this cohort study (n = 21221), patients with clinically diagnosed OSA were matched to controls without OSA to compare the risk of postoperative death and SPCRCs in an administrative database. Results: Compared to non-OSA controls, OSA patients were at increased risk of postoperative respiratory failure both before and after diagnosis with OSA. Prior to diagnosis, OSA patients, particularly those with severe OSA, were also at increased risk of cardiac arrest and SPCRCs . After diagnosis with OSA, except for postoperative respiratory failure, the risk of SPCRC’s was not different from controls. Also, the risk of postoperative death among OSA patients after diagnosis was not different from controls. Other important predictors of SPCRCs and death included admission in an intensive care unit at the time of surgery, a history of congestive heart failure, a higher Charlson comorbidity index score and the type of surgery. Conclusions: OSA was associated with an increased risk of SPCRCs, especially prior to diagnosis and in severe disease. This suggests that screening for and treating OSA in preoperative patients would reduce the risk of SPCRCs. However, the significant influences of the type of surgery and the presence of medical comorbidities on the risks of SPCRCs and death, regardless of the presence of OSA, must be considered in planning efficient and equitable interventions to reduce these risks.
URI: http://hdl.handle.net/1993/8114
Appears in Collection(s):FGS - Electronic Theses & Dissertations (Public)

Files in This Item:

File Description SizeFormat
mutter_thomas.pdf1.69 MBAdobe PDFView/Open
View Statistics

Items in MSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

 

Valid XHTML 1.0! MSpace Software Copyright © 2002-2010  Duraspace - Feedback