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Polysomnography in pre-operative screening for obstructive sleep apnea in patients undergoing bariatric surgery: a retrospective cohort study

International Journal of Obesity volume 46, pages 802–808 (2022)Cite this article

Subjects

Abstract

Background/Objectives

To assess the impact of obstructive sleep apnea (OSA) screening with polysomnography on preventing cardiovascular and pulmonary complications in the postoperative period of bariatric surgery.

Subjects/Methods

This was a single-center retrospective cohort study, including 522 adults who underwent bariatric surgery between August 2010 and May 2019. Electronic medical records were accessed to obtain variables of interest. Screening for OSA was performed as a medical indication and registered as positive if apnea–hypopnea index was ≥5 events/hour in patients who did not have previous OSA diagnosis. The primary outcome was the presence of cardiac or pulmonary events in the 30-day postoperative period. Secondary outcomes included length of stay (days), need for an intensive care unit (ICU) after surgery, length of mechanical ventilation, and time from mechanical ventilation withdrawal. Statistical analyses were performed with χ2, Fisher’s exact test, Student’s t-test, Mann–Whitney U test, and Poisson regression.

Results

Most participants (n = 326) did not have OSA screening with polysomnography, while 196 had performed this screening. There was no difference in cardiopulmonary events between the screening and non-screening groups (4.2% vs. 2.8%; P = 0.45). Polysomnography screening could not reduce cardiovascular or pulmonary complications in the postoperative period, RR = 1.73 (95% CI: 0.68–4.14). There was no difference in ICU admission, length of stay, and time from mechanical ventilation between groups in secondary outcomes.

Conclusions

Our study suggests that OSA screening with polysomnography in the pre-operative care of bariatric surgery is a dispensable procedure, as it does not change postoperative cardiopulmonary outcomes. Indications for polysomnography should be made at the individual level.

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Acknowledgements

This work was conducted with support from Pontifícia Universidade Católica do the Rio Grande do Sul and especially the Postgraduate Program in Medicine and health sciences of this university. Also, this work had support from Hospital de Clínicas de Porto Alegre and its Endocrinology Division.

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Authors and Affiliations

  1. Post-graduate Program in Medicine and Health Sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil

    Taíse Rosa de Carvalho & Gabriela Heiden Telo

  2. Post-graduate Program in Medical Science: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil

    Carina Andriatta Blume, Janine Alessi & Beatriz D. Schaan

  3. Endocrinology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil

    Beatriz D. Schaan

Authors
  1. Taíse Rosa de Carvalho
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  2. Carina Andriatta Blume
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  5. Gabriela Heiden Telo
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Contributions

TRdC was responsible for designing the study protocol, collecting, extracting, and analyzing data, interpreting and writing results, updating reference lists, and creating tables. CAB was responsible for selecting eligible participants, extracting data, and interpreting results. JA was responsible for analyzing and interpreting data and critically revising the paper. BDS was responsible for designing the study protocol, selecting eligible participants, interpreting data, and critically revising the paper. GHT was for designing the study protocol, analyzing data, interpreting results critically, and revising the paper.

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Correspondence to Taíse Rosa de Carvalho.

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Competing interests

TRdC’s work has not received funding for performing the project. She, otherwise, has received a personal grant from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) during the project development.

Ethical approval

The institutional ethics committee approved the study protocol, and all authors signed the confidentiality document for data use. Certification of presentation of scientific appraisal was conceived by protocol number 81433317500005327, approved by commission resolution number 2492350.

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de Carvalho, T.R., Blume, C.A., Alessi, J. et al. Polysomnography in pre-operative screening for obstructive sleep apnea in patients undergoing bariatric surgery: a retrospective cohort study. Int J Obes 46, 802–808 (2022). https://doi.org/10.1038/s41366-021-01055-2

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