Patients undergoing surgical interventions
under general anesthesia, obstructive sleep apnea syndrome
(OSA) can cause serious perioperative cardiovascular or
respiratory complications leading to fatal consequences,
even sudden death. In this study we test the hypothesis that
morbidly obese patients diagnosed by a polysomnography
test and using continuous positive airway pressure (CPAP)
therapy have fewer and less severe perioperative complications
and a shorter hospital stay than patients who have a
medical history that meets at least three STOP-Bang criteria
and are not using CPAP therapy.
Methods Postoperative hospital stay and pulmonary
complications were analyzed in three groups of morbidly
obese patients undergoing bariatric surgery (Roux-en-Y
gastric bypass and laparoscopic sleeve gastrectomy)
between January 2009 and November 2013 (n = 693).
Group A comprised 99 patients who were preoperatively
diagnosed with OSA based on polysomnography results.
These patients used CPAP therapy before and after surgery.
Group B consisted of 182 patients who met at least three
STOP-Bang criteria but who were not diagnosed with OSA
based on polysomnography results. These patients did not
use CPAP. Group C, the reference group, comprised 412
patients who scored one to two items on the STOP-Bang.
Results During the perioperative period, Group B patients
had a significantly (p\0.001) higher cumulative rate of
pulmonary complications, worse oxygen saturation, respiratory
rates, and increased length of stay in hospital. There
was also two cases of sudden death in this group.
Conclusion Based on these results, we conclude that
patients meeting at least three STOP-BANG criteria have
higher postoperative complications and an increased length
of hospital stay than patients using CPAP.
Keywords Obstructive sleep apnea syndrome Morbid
obesity Postoperative complications Sudden death