Effect of obstructive sleep apnea on postoperative delirium: a system review and meta-analysis.

IF 2.1 4区 医学 Q3 CLINICAL NEUROLOGY
Sleep and Breathing Pub Date : 2024-10-01 Epub Date: 2024-06-11 DOI:10.1007/s11325-024-03073-6
Yao Xiao, Pei-Jun Li, Meng-Yao Guo, Yuan Cao, Zong-An Liang
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引用次数: 0

Abstract

Purpose: To investigate the impact of obstructive sleep apnea (OSA) on postoperative delirium (PD), and evaluate the effectiveness of positive airway pressure (PAP) therapy on PD among OSA patients.

Methods: We systematically searched Embase, Cochrane Library and PubMed databases from their establishment to November 27, 2022. A random-effects approach was employed to determine aggregated results. Subgroup and sensitivity analyses were carried out to investigate heterogeneity.

Results: Sixteen eligible studies were included in the analysis. Thirteen studies revealed that OSA significantly elevated the likelihood of developing PD (OR = 1.71; 95%CI = 1.17 to 2.49; p = 0.005). Subgroup analysis according to delirium assessment scales showed that OSA did not exhibit an association with the incidence of PD assessed by the Confusion Assessment Method-Intensive Care Unit (OR = 1.14; 95%CI = 0.77 to 1.67; p = 0.51) but enhanced the likelihood of developing PD evaluated with other measurement scales (OR = 2.15; 95%CI = 1.44 to 3.19; p = 0.0002). Three additional studies explored the impact of PAP treatment on PD among OSA individuals, indicating no significant reduction in PD incidence with PAP use (OR = 0.58; 95%CI = 0.13 to 2.47; p = 0.46).

Conclusions: OSA may not be a risk factor for PD in critically ill patients in the intensive care unit, but may increase the likelihood of developing PD among individuals receiving regular care in the ward postoperatively. The efficacy of PAP therapy in decreasing PD incidence among OSA patients remains debatable.

Abstract Image

阻塞性睡眠呼吸暂停对术后谵妄的影响:系统回顾和荟萃分析。
目的:研究阻塞性睡眠呼吸暂停(OSA)对术后谵妄(PD)的影响,并评估气道正压(PAP)疗法对OSA患者术后谵妄的疗效:我们系统地检索了 Embase、Cochrane Library 和 PubMed 数据库从建立到 2022 年 11 月 27 日的内容。我们采用随机效应法来确定综合结果。为了研究异质性,还进行了分组和敏感性分析:16项符合条件的研究被纳入分析。13项研究显示,OSA会显著增加罹患PD的可能性(OR = 1.71; 95%CI = 1.17 to 2.49; p = 0.005)。根据谵妄评估量表进行的亚组分析表明,OSA与重症监护病房意识模糊评估法(Confusion Assessment Method-Intensive Care Unit)评估的谵妄发生率没有关系(OR = 1.14;95%CI = 0.77 to 1.67;p = 0.51),但与其他测量量表评估的谵妄发生率有关系(OR = 2.15;95%CI = 1.44 to 3.19;p = 0.0002)。另有三项研究探讨了呼吸机治疗对 OSA 患者猝死症的影响,结果表明使用呼吸机并不会显著降低猝死症的发病率(OR = 0.58;95%CI = 0.13 至 2.47;P = 0.46):结论:对于重症监护室的危重症患者来说,OSA 可能不是肢端麻痹症的危险因素,但对于术后在病房接受常规护理的患者来说,OSA 可能会增加肢端麻痹症的发病几率。PAP疗法在降低OSA患者垂体促肾上腺皮质激素发病率方面的疗效仍有待商榷。
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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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