Abstract
AbstractCardiac surgery is associated with high rates of postoperative delirium. The development of postoperative delirium increases morbidity, mortality and healthcare costs. Sleep disordered breathing is highly prevalent in patients undergoing cardiac surgery, and now appears likely to be an independent risk factor for postoperative delirium. If confirmed in larger controlled trials, sleep apnea may represent a risk factor for targeted intervention to reduce the rate of postoperative delirium.
Highlights
Postoperative delirium following cardiac surgery is extremely common and represents a challenging problem for perioperative care providers
A more recent prospective study found that older patients with polysomnogram-proven obstructive sleep apnea (OSA) undergoing hip and knee surgery more frequently experienced postoperative delirium than those without a known diagnosis of OSA (53% vs 20%, P = 0.01) [7]
Utilizing a portable limited-channel sleep monitoring system, they found that 59% of the study population had at least moderate to severe sleep apnea (apnea–hypopnea index (AHI) ≥15), and that the presence of preoperative sleep disordered breathing was associated with the development of delirium in the first 48 hours following surgery [1]
Summary
Postoperative delirium following cardiac surgery is extremely common and represents a challenging problem for perioperative care providers. It has been associated with increased length of hospital stay, postoperative morbidity (including prolonged cognitive dysfunction) and increased mortality. While multiple factors have been associated with delirium in the postoperative setting, evidence is mounting linking sleep apnea to this serious postoperative complication
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