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Clinical Research in Cardiology

, Volume 107, Issue 12, pp 1148–1159 | Cite as

Postoperative complications after elective coronary artery bypass grafting surgery in patients with sleep-disordered breathing

  • Maria TafelmeierEmail author
  • Teresa Weizenegger
  • Sarah Ripfel
  • Miriam Fauser
  • Bernhard Floerchinger
  • Daniele Camboni
  • York Zausig
  • Sigrid Wittmann
  • Marzena A. Drzymalski
  • Florian Zeman
  • Christof Schmid
  • Lars S. Maier
  • Stefan Wagner
  • Michael Arzt
Original Paper

Abstract

Background

Sleep-disordered breathing (SDB) may increase the risk of postoperative complications in patients after cardiac surgery. This study evaluated the length of hospital stay as well as postoperative cardiac, respiratory, and renal complications after elective coronary artery bypass grafting (CABG) in patients without SDB, with central sleep apnea (CSA), or with obstructive sleep apnea (OSA).

Methods

The presence and type of SDB had been assessed with polygraphic recordings in 100 patients the night before elective CABG surgery. SDB was defined as an apnea–hypopnea index (AHI) of ≥ 15/h. Prolonged length of hospital stay (LOS) and postoperative hemodynamic instability due to any cause were retrospectively evaluated as primary endpoints and cardiac, respiratory, and renal complications as secondary endpoints.

Results

37% of patients had SDB, 14% CSA, and 23% OSA. LOS differed significantly between patients without SDB and those with CSA and OSA [median (25;75. percentile): 8.0 days (7.5;11.0) vs. 9.5 days (7.0;12.5) vs. 12.0 days (9.0;17.0), Kruskal–Wallis test between three groups: p = 0.023; OSA vs. no SDB: p = 0.005]. AHI was significantly associated with prolonged LOS [> 9 days; odds ratio (OR) (95% confidence interval): 1.047 (1.001;1.095), p = 0.044]. Prolonged need of vasopressors (≥ 48 h) was observed in 36% of patients without SDB, in 64% with CSA, and in 62% with OSA (p = 0.037). AHI was significantly associated with prolonged (≥ 48 h) need of vasopressors [OR (95% CI): 1.052 (1.002;1.104), p = 0.040], independent of any confounders.

Conclusions

SDB, particularly OSA, is associated with prolonged LOS after CABG, independent of known confounders. Prolonged LOS in patients with SDB may be due to increased postoperative hemodynamic instability due to any cause.

Keywords

Cardiac surgery Coronary artery bypass grafting Coronary artery disease Sleep apnea 

Notes

Compliance with ethical standards

Conflict of interest

MA has received research grants and lecture fees from Philips Respironics and ResMed. The remaining authors declare no conflict of interest.

Supplementary material

392_2018_1289_MOESM1_ESM.docx (2.8 mb)
Supplementary material 1 (DOCX 2817 KB)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Maria Tafelmeier
    • 1
    Email author
  • Teresa Weizenegger
    • 1
  • Sarah Ripfel
    • 1
  • Miriam Fauser
    • 1
  • Bernhard Floerchinger
    • 2
  • Daniele Camboni
    • 2
  • York Zausig
    • 3
  • Sigrid Wittmann
    • 3
  • Marzena A. Drzymalski
    • 1
  • Florian Zeman
    • 4
  • Christof Schmid
    • 2
  • Lars S. Maier
    • 1
  • Stefan Wagner
    • 1
  • Michael Arzt
    • 1
  1. 1.Department of Internal Medicine II (Cardiology, Pneumology, and Intensive Care)University Medical Centre RegensburgRegensburgGermany
  2. 2.Department of Cardiothoracic SurgeryUniversity Medical Centre RegensburgRegensburgGermany
  3. 3.Department of AnaesthesiologyUniversity Medical Centre RegensburgRegensburgGermany
  4. 4.Centre for Clinical StudiesUniversity Medical Centre RegensburgRegensburgGermany

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