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Serious postoperative cardiovascular and respiratory complications in obstructive sleep apnea patients: matched cohort analysis of clinical and administrative data

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dc.contributor.supervisor Roos, Leslie (Community Health Sciences) en_US
dc.contributor.author Mutter, Thomas Charles
dc.date.accessioned 2012-07-23T16:18:29Z
dc.date.available 2012-07-23T16:18:29Z
dc.date.issued 2012-07-23
dc.identifier.uri http://hdl.handle.net/1993/8114
dc.description.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. en_US
dc.rights info:eu-repo/semantics/openAccess
dc.subject surgery en_US
dc.subject anesthesia en_US
dc.subject complications en_US
dc.subject arrest en_US
dc.subject cardiac en_US
dc.title Serious postoperative cardiovascular and respiratory complications in obstructive sleep apnea patients: matched cohort analysis of clinical and administrative data en_US
dc.type info:eu-repo/semantics/masterThesis
dc.degree.discipline Community Health Sciences en_US
dc.contributor.examiningcommittee Moffatt, Michael (Community Health Sciences) Ramsey, Clare (Community Health Sciences) Kryger, Meir (Yale University) en_US
dc.degree.level Master of Science (M.Sc.) en_US
dc.description.note October 2012 en_US


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