High risk for obstructive sleep apnea hypopnea syndrome predicts new onset atrial fibrillation after cardiac surgery: a retrospective analysis

Samir V. Patel, Harmeet Gill, Diwas Shahi, Ajai Rajabalan, Palak Patel, Rajesh Sonani, Parth Bhatt, Rafael David Rodriguez, Manuel Bautista, Abhishek Deshmukh, Juan Viles Gonzalez, Sanjay Patel

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose: Obstructive sleep apnea hypopnea syndrome (OSAHS) is highly prevalent in patients undergoing coronary artery bypass surgery (CABG). OSAHS is a risk factor for the development of atrial fibrillation (AF), but the risk of AF in patients who are high risk for OSAHS is unclear. Methods: A retrospective study was conducted on consecutive patients undergoing CABG from 2013 to 2015 without AF pre-operatively. Patients were categorized as low risk for OSAHS, high risk for OSAHS, or diagnosed OSAHS based on medical records review. All diagnosed OSAHS patients were on active treatment with positive airway pressure. Outcomes assessed were postoperative AF (POAF), postoperative length of stay, re-intubation, in-hospital mortality, and cost of hospitalization. Results: Out of 209 eligible patients, 66.5% were low-risk for OSAHS, 18.7% high-risk for OSAHS, and 14.8% diagnosed/treated for OSAHS. POAF developed in 96 patients (45.9%) with greater frequency in high-risk OSAHS patients (69.2% high risk, 41.9% low risk, 40.3% diagnosed/treated, p = 0.01). In analyses adjusted for age, sex, ethnicity and comorbidities, high risk for OSAHS was associated with 2.9 greater odds (95% CI [1.2, 7.3], p = 0.02) for POAF while diagnosed/treated OSAHS was not associated with elevated risk (OR = 1.4, 95% CI [0.6, 3.6], p = 0.50) compared to patients at low risk for OSAHS. Conclusions: High risk for OSAHS is an independent predictor for POAF in patients undergoing CABG. In contrast, patients diagnosed and treated for their OSAHS are not at elevated risk of POAF. These findings support evaluation of a standardized OSAHS screening and treatment program as part of the pre-operative evaluation for elective CABG.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalSleep and Breathing
DOIs
StateAccepted/In press - Feb 19 2018
Externally publishedYes

Fingerprint

Obstructive Sleep Apnea
Atrial Fibrillation
Thoracic Surgery
Coronary Artery Bypass

Keywords

  • Atrial fibrillation
  • Coronary artery bypass graft surgery
  • Cost
  • Length of stay
  • Mortality
  • Screening
  • Sleep apnea

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Clinical Neurology

Cite this

High risk for obstructive sleep apnea hypopnea syndrome predicts new onset atrial fibrillation after cardiac surgery : a retrospective analysis. / Patel, Samir V.; Gill, Harmeet; Shahi, Diwas; Rajabalan, Ajai; Patel, Palak; Sonani, Rajesh; Bhatt, Parth; Rodriguez, Rafael David; Bautista, Manuel; Deshmukh, Abhishek; Viles Gonzalez, Juan; Patel, Sanjay.

In: Sleep and Breathing, 19.02.2018, p. 1-8.

Research output: Contribution to journalArticle

Patel, SV, Gill, H, Shahi, D, Rajabalan, A, Patel, P, Sonani, R, Bhatt, P, Rodriguez, RD, Bautista, M, Deshmukh, A, Viles Gonzalez, J & Patel, S 2018, 'High risk for obstructive sleep apnea hypopnea syndrome predicts new onset atrial fibrillation after cardiac surgery: a retrospective analysis', Sleep and Breathing, pp. 1-8. https://doi.org/10.1007/s11325-018-1645-3
Patel, Samir V. ; Gill, Harmeet ; Shahi, Diwas ; Rajabalan, Ajai ; Patel, Palak ; Sonani, Rajesh ; Bhatt, Parth ; Rodriguez, Rafael David ; Bautista, Manuel ; Deshmukh, Abhishek ; Viles Gonzalez, Juan ; Patel, Sanjay. / High risk for obstructive sleep apnea hypopnea syndrome predicts new onset atrial fibrillation after cardiac surgery : a retrospective analysis. In: Sleep and Breathing. 2018 ; pp. 1-8.
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abstract = "Purpose: Obstructive sleep apnea hypopnea syndrome (OSAHS) is highly prevalent in patients undergoing coronary artery bypass surgery (CABG). OSAHS is a risk factor for the development of atrial fibrillation (AF), but the risk of AF in patients who are high risk for OSAHS is unclear. Methods: A retrospective study was conducted on consecutive patients undergoing CABG from 2013 to 2015 without AF pre-operatively. Patients were categorized as low risk for OSAHS, high risk for OSAHS, or diagnosed OSAHS based on medical records review. All diagnosed OSAHS patients were on active treatment with positive airway pressure. Outcomes assessed were postoperative AF (POAF), postoperative length of stay, re-intubation, in-hospital mortality, and cost of hospitalization. Results: Out of 209 eligible patients, 66.5{\%} were low-risk for OSAHS, 18.7{\%} high-risk for OSAHS, and 14.8{\%} diagnosed/treated for OSAHS. POAF developed in 96 patients (45.9{\%}) with greater frequency in high-risk OSAHS patients (69.2{\%} high risk, 41.9{\%} low risk, 40.3{\%} diagnosed/treated, p = 0.01). In analyses adjusted for age, sex, ethnicity and comorbidities, high risk for OSAHS was associated with 2.9 greater odds (95{\%} CI [1.2, 7.3], p = 0.02) for POAF while diagnosed/treated OSAHS was not associated with elevated risk (OR = 1.4, 95{\%} CI [0.6, 3.6], p = 0.50) compared to patients at low risk for OSAHS. Conclusions: High risk for OSAHS is an independent predictor for POAF in patients undergoing CABG. In contrast, patients diagnosed and treated for their OSAHS are not at elevated risk of POAF. These findings support evaluation of a standardized OSAHS screening and treatment program as part of the pre-operative evaluation for elective CABG.",
keywords = "Atrial fibrillation, Coronary artery bypass graft surgery, Cost, Length of stay, Mortality, Screening, Sleep apnea",
author = "Patel, {Samir V.} and Harmeet Gill and Diwas Shahi and Ajai Rajabalan and Palak Patel and Rajesh Sonani and Parth Bhatt and Rodriguez, {Rafael David} and Manuel Bautista and Abhishek Deshmukh and {Viles Gonzalez}, Juan and Sanjay Patel",
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T1 - High risk for obstructive sleep apnea hypopnea syndrome predicts new onset atrial fibrillation after cardiac surgery

T2 - a retrospective analysis

AU - Patel, Samir V.

AU - Gill, Harmeet

AU - Shahi, Diwas

AU - Rajabalan, Ajai

AU - Patel, Palak

AU - Sonani, Rajesh

AU - Bhatt, Parth

AU - Rodriguez, Rafael David

AU - Bautista, Manuel

AU - Deshmukh, Abhishek

AU - Viles Gonzalez, Juan

AU - Patel, Sanjay

PY - 2018/2/19

Y1 - 2018/2/19

N2 - Purpose: Obstructive sleep apnea hypopnea syndrome (OSAHS) is highly prevalent in patients undergoing coronary artery bypass surgery (CABG). OSAHS is a risk factor for the development of atrial fibrillation (AF), but the risk of AF in patients who are high risk for OSAHS is unclear. Methods: A retrospective study was conducted on consecutive patients undergoing CABG from 2013 to 2015 without AF pre-operatively. Patients were categorized as low risk for OSAHS, high risk for OSAHS, or diagnosed OSAHS based on medical records review. All diagnosed OSAHS patients were on active treatment with positive airway pressure. Outcomes assessed were postoperative AF (POAF), postoperative length of stay, re-intubation, in-hospital mortality, and cost of hospitalization. Results: Out of 209 eligible patients, 66.5% were low-risk for OSAHS, 18.7% high-risk for OSAHS, and 14.8% diagnosed/treated for OSAHS. POAF developed in 96 patients (45.9%) with greater frequency in high-risk OSAHS patients (69.2% high risk, 41.9% low risk, 40.3% diagnosed/treated, p = 0.01). In analyses adjusted for age, sex, ethnicity and comorbidities, high risk for OSAHS was associated with 2.9 greater odds (95% CI [1.2, 7.3], p = 0.02) for POAF while diagnosed/treated OSAHS was not associated with elevated risk (OR = 1.4, 95% CI [0.6, 3.6], p = 0.50) compared to patients at low risk for OSAHS. Conclusions: High risk for OSAHS is an independent predictor for POAF in patients undergoing CABG. In contrast, patients diagnosed and treated for their OSAHS are not at elevated risk of POAF. These findings support evaluation of a standardized OSAHS screening and treatment program as part of the pre-operative evaluation for elective CABG.

AB - Purpose: Obstructive sleep apnea hypopnea syndrome (OSAHS) is highly prevalent in patients undergoing coronary artery bypass surgery (CABG). OSAHS is a risk factor for the development of atrial fibrillation (AF), but the risk of AF in patients who are high risk for OSAHS is unclear. Methods: A retrospective study was conducted on consecutive patients undergoing CABG from 2013 to 2015 without AF pre-operatively. Patients were categorized as low risk for OSAHS, high risk for OSAHS, or diagnosed OSAHS based on medical records review. All diagnosed OSAHS patients were on active treatment with positive airway pressure. Outcomes assessed were postoperative AF (POAF), postoperative length of stay, re-intubation, in-hospital mortality, and cost of hospitalization. Results: Out of 209 eligible patients, 66.5% were low-risk for OSAHS, 18.7% high-risk for OSAHS, and 14.8% diagnosed/treated for OSAHS. POAF developed in 96 patients (45.9%) with greater frequency in high-risk OSAHS patients (69.2% high risk, 41.9% low risk, 40.3% diagnosed/treated, p = 0.01). In analyses adjusted for age, sex, ethnicity and comorbidities, high risk for OSAHS was associated with 2.9 greater odds (95% CI [1.2, 7.3], p = 0.02) for POAF while diagnosed/treated OSAHS was not associated with elevated risk (OR = 1.4, 95% CI [0.6, 3.6], p = 0.50) compared to patients at low risk for OSAHS. Conclusions: High risk for OSAHS is an independent predictor for POAF in patients undergoing CABG. In contrast, patients diagnosed and treated for their OSAHS are not at elevated risk of POAF. These findings support evaluation of a standardized OSAHS screening and treatment program as part of the pre-operative evaluation for elective CABG.

KW - Atrial fibrillation

KW - Coronary artery bypass graft surgery

KW - Cost

KW - Length of stay

KW - Mortality

KW - Screening

KW - Sleep apnea

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