title: Postoperative complications in patients with obstructive sleep apnea: a meta-analysis.
abstract: OBJECTIVE
  To determine whether a diagnosis of obstructive sleep apnea (OSA) imparts an increased risk of postoperative respiratory failure, cardiac events, and intensive care unit (ICU) transfer than patients with no OSA diagnosis.
  
  
  METHODS
  Systematic review and meta-analysis.
  
  
  METHODS
  Academic Veterans Affairs Medical Center.
  
  
  METHODS
  PubMed, EMBASE, CINAHL, and ISI Web of Knowledge databases were searched through April 2013 for studies that examined the relationship between OSA and postoperative respiratory and cardiac complications among adults. Either fixed or random-effects models were used to calculate the pooled risk estimates. Sensitivity analysis was conducted to examine the robustness of pooled outcomes.
  
  
  RESULTS
  Seventeen studies with a total of 7,162 patients were included. Overall, OSA was associated with significant increase in risk of respiratory failure [odds ratio (OR) 2.42; 95% confidence intervals (CI) 1.53 - 3.84; P = 0.0002] and cardiac events postoperatively (OR = 1.63; 95% CI 1.16 - 2.29; P = 0.005). Heterogeneity was low for these outcomes (I(2) = 5% and 0%, respectively). ICU transfer occurred also more frequently in patients with OSA (OR 2.46; 95% CI 1.29 - 4.68; P = 0.006). These results did not materially change in the sensitivity analyses according to various inclusion criteria.
  
  
  CONCLUSIONS
  Surgical patients with OSA are at increased risk of postoperative respiratory failure, cardiac events, and ICU transfer.
authors.affiliation: The Veterans Affairs Western New York Healthcare System, Western New York, Buffalo, NY 14215-1199, USA; Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY 14260, USA.
authors.forename: Faizi
authors.initials: F
authors.lastname: Hai
authors.affiliation: The Veterans Affairs Western New York Healthcare System, Western New York, Buffalo, NY 14215-1199, USA; Department of Anesthesiology, University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY 14260, USA.
authors.forename: Jahan
authors.initials: J
authors.lastname: Porhomayon
authors.affiliation: The Veterans Affairs Western New York Healthcare System, Western New York, Buffalo, NY 14215-1199, USA; Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY 14260, USA.
authors.forename: Leah
authors.initials: L
authors.lastname: Vermont
authors.affiliation: The Veterans Affairs Western New York Healthcare System, Western New York, Buffalo, NY 14215-1199, USA; Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY 14260, USA.
authors.forename: Lynne
authors.initials: L
authors.lastname: Frydrych
authors.affiliation: The Veterans Affairs Western New York Healthcare System, Western New York, Buffalo, NY 14215-1199, USA; Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY 14260, USA.
authors.forename: Philippe
authors.initials: P
authors.lastname: Jaoude
authors.affiliation: The Veterans Affairs Western New York Healthcare System, Western New York, Buffalo, NY 14215-1199, USA; Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY 14260, USA; Department of Anesthesiology, University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY 14260, USA; Department of Social Preventive Medicine, University at Buffalo School of Medicine Biomedical Sciences, Buffalo, NY 14214, USA. Electronic address: solh@buffalo.edu.
authors.forename: Ali A
authors.initials: AA
authors.lastname: El-Solh
mesh_terms: D006331:Heart Diseases / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D015233:Models, Statistical; D011183:Postoperative Complications / Q000453:epidemiology*; D012131:Respiratory Insufficiency / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications*
keywords: Postoperative complications; Respiratory failure; Sleep apnea