PREVALENCE OF POST-BARIATRIC SURGERY SLEEP-RELATED COMPLICATIONS IN A TERTIARY HOSPITAL IN SAUDI ARABIA

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SESSION TITLE: Sleep Disorders Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Over the past decade, bariatric surgeries have been on the rise worldwide as an effective way of weight loss. Most patients going for these surgeries are known to have Obstructive Sleep Apnea (OSA) or diagnosed with it while being screened for OSA as part of their pre-operative assessment. Our study aims to detect specific respiratory complications of bariatric surgeries, their relation to the severity of OSA, and how we might anticipate them pre-operatively. METHODS: we did a chart review on patients who underwent bariatric surgeries between the year 2017 to 2019. Our main outcome was respiratory failure and unplanned intubation. secondary outcomes include post-operative Oxygen saturation and oxygen need, unplanned non-invasive ventilation need, and ICU stay. We compared those outcomes to patient's BMI, baseline SpO2, and pre-operative Polysomnography findings. RESULTS: 67 patients underwent bariatric surgery who also had polysomnography prior to surgery. There were 34 males (50.7%) and 33 females (49.3%) with an average age of 37 +/- 12 in this cohort. Their mean Body Mass Index was 50 +/- 10 and baseline O2 was 96%. 67 patients had pre-operative sleep evaluation. 47% of them had severe OSA (AHI >30), 21% had moderate OSA while 14% had no evidence of OSA. 58% had low O2 nadir (o2 saturation <88%) and Oxygen Desaturation Index >10 was observed in 14 patients (20%) The Majority of patients underwent laparoscopic sleeve surgery (77%). Post-operatively, 3 patients had unplanned ICU admission secondary to hypoxic/hypercapnic respiratory failure. One of them had intubation while the other two received Non-Invasive Ventilation. All these patients had severe OSA with an average AHI 80 events/hour. 13 patients (19.4%) needed oxygen for post-operative hypoxia and 13 patients needed unplanned Positive Airway Pressure device (PAP). There was a correlation between the severity of OSA and the unplanned PAP use postoperatively (Pearson chi2 = 9.2394, P-value = 0.026) and correlation with post-operative hypoxia that required O2 therapy which didn’t reach statistical significance (Pearson chi2 = 6.5301 P = 0.088). There was no correlation between postoperative respiratory complications and other variables in polysomnography such as Oxygen Desaturation Index or Oxygen nadir. CONCLUSIONS: There were few major post-operative respiratory complications in this study given its small cohort size. There was a correlation between the severity of sleep apnea and minor respiratory complications such as post-operative mild-moderate hypoxia. CLINICAL IMPLICATIONS: It is suggested to screen patients for OSA prior to bariatric surgeries as this will help in detecting high-risk patients for post-operative complications. Further and larger studies are needed to evaluate the effect of different PSG parameters on post-bariatric surgery respiratory complications. DISCLOSURES: No relevant relationships by MUHAMMAD ABUKHATER, source=Web Response No relevant relationships by Riyad Al-Lehebi, source=Web Response no disclosure on file for Abdullah AlJasser; no disclosure on file for Nasser Aljohani; no disclosure on file for Rana AlTurki