title: Obstructive sleep apnea and postoperative complications among patients undergoing gynecologic oncology surgery.
abstract: OBJECTIVE
  To investigate the prevalence of obstructive sleep apnea (OSA), physiological or risk factors associated with OSA, and OSA-associated postoperative complications among patients undergoing gynecologic oncology surgery.
  
  
  METHODS
  A prospective observational study enrolled gynecologic oncology patients undergoing abdominal surgery at a center in the UK between August 2009 and January 2013. All patients underwent perioperative sleep oximetry for the diagnosis of OSA. Data assessed included the body mass index, the STOP-Bang score, the Epworth Sleepiness Scale score, the apnea-hypopnea index, and postoperative complications. Associations were determined between preoperative OSA and postoperative OSA, postoperative complications, and risk factors such as body mass index, age, STOP-Bang score, and Epworth score.
  
  
  RESULTS
  Among 160 participants, 72 (45.0%) were obese and 80 (50.0%) had OSA. Obesity, older age (more than 65 years), and a neck circumference of 40 cm or more were significantly associated with OSA. Overall, 58 (36.3%) patients had postoperative complications; 21 (13.1%) had surgical complications and 37 (23.1%) had medical complications. Complications were not associated with OSA (P=0.612). Four (2.5%) patients died; mortality was not associated with OSA (P=0.810).
  
  
  CONCLUSIONS
  OSA is common among gynecologic oncology patients. Portable sleep oximetry identifies gynecology patients who have OSA or require postoperative critical care. Obesity is associated with OSA, but OSA is not associated with postoperative complications in gynecologic oncology patients.
authors.affiliation: Department of Anaesthesia, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Olumuyiwa A
authors.initials: OA
authors.lastname: Bamgbade
authors.affiliation: Department of Surgery, University of Manchester, Manchester, UK.
authors.forename: Rong R
authors.initials: RR
authors.lastname: Khaw
authors.affiliation: Department of Surgery, University of Manchester, Manchester, UK.
authors.forename: Raisah S
authors.initials: RS
authors.lastname: Sawati
authors.affiliation: Department of Gynaecology, University of Manchester, Manchester, UK.
authors.forename: Cathrine M
authors.initials: CM
authors.lastname: Holland
mesh_terms: D034841:Abdominal Cavity / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005833:Genital Neoplasms, Female / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects* / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D010092:Oximetry; D011183:Postoperative Complications; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D055815:Young Adult
keywords: Gynecologic oncology; Obesity; Obstructive sleep apnea; Portable sleep oximetry; Postoperative complications