O154 Outcomes of bariatric surgery among patients with obstructive sleep apnoea: a systematic review, meta-analysis and a retrospective database analysis

Abstract

Abstract Introduction Obstructive sleep apnoea (OSA) is highly prevalent among patients undergoing bariatric surgery. Previous studies have reported a higher risk of complications, longer hospital stays and ICU admissions among OSA patients following general surgery but clinical outcomes following bariatric surgery remain unclear. Therefore, we evaluated the risk of adverse outcomes among OSA patients undergoing bariatric surgery. Methods We undertook a systematic review and meta-analysis followed by retrospective database analysis. Searches were performed using PubMed and Ovid Medline. Bariatric surgery studies that compared OSA and non-OSA patients that utilised outcome measures that included length of stay, risk of complications, readmission within 30 days and need for ICU admission were selected. Retrospective data analysis of patient records was conducted from the Royal Derby Hospital (RDH) bariatric surgery database by comparing OSA patients (N=49) and non-OSA (N=86) patients using the same outcome measures. Results Patients with OSA are at greater risk of complications after bariatric surgery (RR=1.23; CI:1.01,1.5, P=0.04), driven largely by an increased risk of cardiac complications (RR=2.44; CI:1.26,4.76, P=0.009). There were no significant differences between the OSA and non-OSA cohorts in the other outcome variables. Clinical evaluation at RDH showed no significant differences between OSA and non-OSA patients in terms of length of stay, need for ICU admission, risk of complications and 30-day readmission. Conclusion Following bariatric surgery, patients with OSA must be managed carefully due to the increased risk of cardiac complications. However, patients with OSA are not more likely to require a longer length of stay or readmission.