Meta-analysis of associations of sleep disordered breathing with outcomes after cardiac surgery

Abstract

Introduction Sleep disordered breathing (SDB) is a chronic disorder characterized by repeated upper airway collapse during sleep with a high prevalence in patients undergoing cardiac surgery. Although patients with SDB are considered to be at increased risk for postoperative complications after noncardiac surgery, the impact of SDB on postoperative outcomes after cardiac surgery remains obscure. Results Nineteen eligible studies including 3992 patients were identified. SDB was significantly associated with postoperative all-cause mortality (OR 2.44, 95% CI 1.08–5.49), atrial fibrillation (OR 2.15, 95% CI 1.67–2.77), pulmonary complications (OR 2.02, 95% CI 1.20–3.39), acute kidney injury (OR 2.82, 95% CI 1.19–6.66), delirium (OR 6.4, 95% CI 2.6–15.4), and long-term major adverse cardiovascular events (MACE) (OR 3.44, 95% CI 1.43–8.25), but not short-term MACE (OR 1.64, 95% CI 0.57–4.74) or infection (OR 1.50, 95% CI 0.75–3.01). Increasing severity of SDB might be associated with worsened outcomes. Discussion SDB is associated with increased risk of mortality and morbidity after cardiac surgery. Future studies need to explore the optimal screening methods and interventions for SDB in the perioperative period.