阻塞性睡眠呼吸暂停对冠状动脉旁路移植术患者术后效果的影响:系统回顾和荟萃分析。

IF 2.1 4区 医学 Q3 CLINICAL NEUROLOGY Sleep and Breathing Pub Date : 2024-09-06 DOI:10.1007/s11325-024-03154-6
Yajing Ni, Yan Zhou
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引用次数: 0

摘要

目的评估阻塞性睡眠呼吸暂停(OSA)与冠状动脉旁路移植术(CABG)患者术后并发症之间的关系:对 PubMed、Embase、Web of Science 和 Scopus 数据库进行了检索,以确定报告了 CABG 患者 OSA 发生率的相关观察性研究,并使用标准的客观方法(如多导睡眠图 (PSG))对 OSA 进行评估。主要研究结果为主要不良心脑血管事件(MACCE)风险和全因死亡率。汇总效应大小以几率比(OR)和 95% 置信区间的形式报告:结果:共纳入 12 项研究。除一项研究外,所有研究均采用前瞻性队列设计。患有 OSA 的 CABG 患者发生 MACCE(OR 1.71,95% CI:1.16, 2.53)、心肌梗死(MI)(OR 2.21,95% CI:1.19, 4.13)、肺部并发症(OR 1.86,95% CI:1.03,3.38)、肾脏并发症(OR 8.14,95% CI:2.07,32.1)、心力衰竭(OR 1.86,95% CI:1.19,2.89)和需要血管重建(OR 2.80,95% CI:1.01,7.75)。然而,所有患者的全因死亡风险(OR 1.63,95% CI:0.75,3.52)相当:本研究表明,OSA 与重大不良事件风险的增加密切相关。我们的研究结果表明,识别和管理 CABG 患者的 OSA 对降低相关风险至关重要。
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Impact of obstructive sleep apnoea on postoperative outcomes of patients undergoing coronary artery bypass grafting: a systematic review and meta-analysis.

Objective: To assess the association between obstructive sleep apnoea (OSA) and postoperative complications in patients after coronary artery bypass graft (CABG).

Methods: PubMed, Embase, Web of Science and Scopus databases were explored to identify relevant observational studies that reported incidences of OSA in CABG patients, and assessed OSA using standard objective methods such as polysomnography (PSG). The primary outcomes of interest were risk of major adverse cardiac and cerebrovascular events (MACCE) and all-cause mortality. Pooled effect sizes were reported as odds ratio (OR) with 95% confidence intervals.

Results: Twelve studies were included. All studies, except one, had a prospective cohort design. CABG patients with OSA had increased risk of MACCE (OR 1.71, 95% CI: 1.16, 2.53), myocardial infarction (MI) (OR 2.21, 95% CI: 1.19, 4.13), pulmonary complications (OR 1.86, 95% CI: 1.03, 3.38), renal complications (OR 8.14, 95% CI: 2.07, 32.1), heart failure (OR 1.86, 95% CI: 1.19, 2.89) and need for revascularization (OR 2.80, 95% CI: 1.01, 7.75). However, risk of all-cause mortality (OR 1.63, 95% CI: 0.75, 3.52) was comparable in all patients.

Conclusion: This study showed that OSA significantly correlates with the increased risk of major adverse events. Our results indicate that recognizing and managing OSA in CABG patients is crucial for mitigating associated risks.

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来源期刊
Sleep and Breathing
Sleep and Breathing 医学-呼吸系统
CiteScore
5.20
自引率
4.00%
发文量
222
审稿时长
3-8 weeks
期刊介绍: The journal Sleep and Breathing aims to reflect the state of the art in the international science and practice of sleep medicine. The journal is based on the recognition that management of sleep disorders requires a multi-disciplinary approach and diverse perspectives. The initial focus of Sleep and Breathing is on timely and original studies that collect, intervene, or otherwise inform all clinicians and scientists in medicine, dentistry and oral surgery, otolaryngology, and epidemiology on the management of the upper airway during sleep. Furthermore, Sleep and Breathing endeavors to bring readers cutting edge information about all evolving aspects of common sleep disorders or disruptions, such as insomnia and shift work. The journal includes not only patient studies, but also studies that emphasize the principles of physiology and pathophysiology or illustrate potentially novel approaches to diagnosis and treatment. In addition, the journal features articles that describe patient-oriented and cost-benefit health outcomes research. Thus, with peer review by an international Editorial Board and prompt English-language publication, Sleep and Breathing provides rapid dissemination of clinical and clinically related scientific information. But it also does more: it is dedicated to making the most important developments in sleep disordered breathing easily accessible to clinicians who are treating sleep apnea by presenting well-chosen, well-written, and highly organized information that is useful for patient care.
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