Systematic review and meta-analysis to examine the impact of preoperative sleep disturbance on post-cardiovascular surgery outcomes: literature search documentation

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Szwajcer, Andrea
Neilson, Christine
Sanjanwala, Rohan
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Objective: Pre-existing sleep disturbances are common in patients undergoing cardiac surgery. The objective of this study was to investigate whether preoperative sleep disturbance impacts postoperative outcomes following cardiac surgery. Methods: Electronic databases, including MEDLINE, EMBASE, CENTRAL, CINAHL, Science Citation Index Expanded, Scopus, and HTA were searched for studies that evaluated the impact of preoperative sleep disturbance on postoperative outcomes in adult patients undergoing cardiac surgical intervention. Adjusted and unadjusted meta-analyses were performed to compare postoperative outcomes, including: postoperative atrial fibrillation, in-hospital mortality, in-hospital length of stay, intensive care unit length of stay, and intensive care unit mortality among patients with and without preoperative sleep disturbance. Results: A total of 17 studies were included (N=2,886 patients). Preoperative sleep disturbance was incrementally associated with a higher risk of mortality (OR 3.75; 95% CI: 1.1.51-9.30), postoperative atrial fibrillation (POAF) (OR 2.11; 95% CI: 1.62-2.75), increased intensive care unit length of stay (LOS) (MD: 0.31; 95% CI, 0.28-0.33), and increased hospital LOS (MD 1.06; 95% CI, 0.34, 1.79). Preoperative sleep disturbance was not significantly associated with higher rates of intensive care unit readmission (OR 1.61; 95% CI, 0.84-3.08). Conclusions: Sleep disturbance was associated with an increased risk of post-operative mortality, POAF, and prolonged hospital and intensive care unit LOS. Early recognition and effective treatment of sleep disturbances may reduce postoperative mortality, morbidity, and health care costs in patients undergoing cardiac surgery. Actual document is the search documentation supporting the dataset.
This study was registered in PROSPERO:
cardiovascular, cardiac, sleep, sleep disturbance, pre-operative, post-operative, search strategy