Peri- and Postoperative Outcomes for Obstructive Sleep Apnoea Patients after Bariatric Surgery—a Systematic Review and Meta-analysis

Katasani, Tarun; Holt, Guy; Al-Khyatt, Waleed; Idris, Iskandar

Abstract

Background
Obstructive sleep apnoea (OSA) is prevalent among patients undergoing bariatric surgery. Previous studies have reported a higher risk of complications, ICU admission and longer length of stay in patients with OSA following surgery. However, clinical outcomes following bariatric surgery are unclear. The hypothesis is that patients with OSA will have an increased risk of these outcome measures after bariatric surgery.

Methods
A systematic review and meta-analysis were performed to answer the research question. Searches for bariatric surgery and obstructive sleep apnoea were performed using PubMed and Ovid Medline. Studies which compared OSA and non-OSA patients undergoing bariatric surgery and used outcome measures that included length of stay, risk of complications, 30-day readmission and need for ICU admission were selected for the systematic review. Comparable datasets from these studies were used for the meta-analysis.

Results
Patients with OSA are at greater risk of complications after bariatric surgery (RR = 1.23 [CI: 1.01, 1.5], P = 0.04), driven mostly by an increased risk of cardiac complications (RR = 2.44 [CI: 1.26, 4.76], P = 0.009). There were no significant differences between the OSA and non-OSA cohorts in the other outcome variables (respiratory complications, length of stay, 30-day readmission and need for ICU admission).

Conclusion
Following bariatric surgery, patients with OSA must be managed carefully due to the increased risk of cardiac complications. However, patients with OSA are not more likely to require a longer length of stay or readmission.

• Journal Article Type: Article
• Acceptance Date: Mar 22, 2023
• Online Publication Date: May 4, 2023
• Publication Date: 2023-07
• Deposit Date: Apr 18, 2023
• Publicly Available Date: May 5, 2024
• Journal: Obesity Surgery
• Print ISSN: 0960-8923
• Electronic ISSN: 1708-0428
• Publisher: Springer Science and Business Media LLC
• Peer Reviewed: Peer Reviewed
• Volume: 33
• Pages: 2016-2024
• DOI: https://doi.org/10.1007/s11695-023-06557-8
• Keywords: Sleep apnoea · Bariatric surgery · Complications · Length of stay · Cardiovascular · Continuous positive airway pressure · CPAP
• Public URL: https://nottingham-repository.worktribe.com/output/19760376
• Publisher URL: https://link.springer.com/article/10.1007/s11695-023-06557-8
• Additional Information: Received: 16 February 2023; Revised: 13 March 2023; Accepted: 21 March 2023; First Online: 4 May 2023; : ; : This was a systematic review and meta-analysis of published studies. An ethical approval is therefore not required.; : This was a meta-analysis of published studies and does not involve human participants.; : The authors declare no competing interests.