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Sleep-Disordered Breathing Associated With Increased Risk of Postoperative Atrial Fibrillation

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A meta-analysis found that postoperative atrial fibrillation in patients undergoing cardiac surgery was associated with sleep-disordered breathing.

Patients undergoing cardiac surgery are at increased risk of postoperative atrial fibrillation (POAF). sleep disordered breathing According to a new review published in (SDB): chronological medicine.

POAF is a clinical complication of cardiac surgery with an incidence of approximately 35%. The potential relationship between SDB and POAF has been evaluated in several studies, particularly the relationship between POAF and obstructive sleep apnea, and the current review uses available publications to It aims to find relationships between SDB and POAF.

Researchers used Scopus, PubMed, Web of Science, EMBASE, Cochrane Central Registry for Controlled Trials, Wanfang Data, Weipu database, and China National Knowledge Infrastructure to extract bibliographic data for articles published before August 2022. I did a search. Data on the relationship between SDB and POAF in patients undergoing cardiac surgery, assessment of SDB status before cardiac surgery, and recording of POAF during postoperative hospitalization or follow-up. All studies were assessed for risk of bias with the Newcastle Ottawa Scale.

The meta-analysis included 24 studies and included 45,361 participants with SDB and 615,324 participants without SDB. These studies were published by him in 11 countries between 1996 and 2022. Eight studies were from the United States, five from China, two from Sweden and Iran, and one from Brazil, Canada, France, Japan, Turkey, Singapore and Italy.

The incidence of POAF in patients with SDB ranged from 8% to 67% and from 6% to 42% in patients without SDB. Atrial fibrillation was diagnosed by continuous electrocardiographic monitoring and electrocardiography, and coronary artery bypass grafting (CABG) was the most common type of surgery.

A 45% higher risk of POAF was found in the SDB group of patients undergoing elective cardiac surgery (odds ratio 1.49; 95% CI 1.30-1.70). In subgroup analyzes conducted using SDB measure, SDB type, study design, and surgical type, excluding patients with a history of atrial fibrillation, SDB was divided by medical device, study with prospective design, and medical history. found to be defined. Excluding a history of atrial fibrillation may increase the association between SDB and POAG.

The meta-analysis had some limitations. Only 24 studies were included, which may not have been sufficient for definitive results. Excluding unpublished data may bias the results. Patients were included after SDB was diagnosed based on score and medical record data. As retrospective studies were included, future investigations and reviews require stricter selection criteria.

The researchers concluded that a meta-analysis found a significant association between SDB and the risk of POAF in patients undergoing cardiac surgery.

“However, more studies need to be performed to validate our results and establish comprehensive management of patients with SBD,” the authors concluded.

reference

Chen Z, Zhang R, Hu X et al. Impact of sleep-disordered breathing on postoperative atrial fibrillation in patients undergoing cardiac surgery: a meta-analysis. Ann MedPublished online November 9, 2022. doi:10.1080/07853890.2022.2143555

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