{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T18:06:44Z","timestamp":1793383604256,"version":"4.5.0"},"reference-count":57,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,3,24]],"date-time":"2022-03-24T00:00:00Z","timestamp":1648080000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009663","name":"University Health Network","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009663","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Identifying surgical patients with obstructive sleep apnoea may assist with anaesthetic management to minimise postoperative complications. Using trial sequential analysis, we evaluated the impact of obstructive sleep apnoea diagnosed by polysomnography or home sleep apnoea testing on postoperative outcomes in surgical patients. Multiple databases were systematically searched. Outcomes included: total postoperative complications, systemic complications (cardiovascular, respiratory, neurological, renal, infectious) and specific complications (atrial fibrillation, myocardial infarction, combined hospital and intensive care unit re\u2010admission, mortality). The pooled odds ratios of postoperative complications were evaluated by the Mantel\u2013Haenszel method random\u2010effects model. Meta\u2010analysis and meta\u2010regression were conducted, and the GRADE approach was used to evaluate the certainty of evidence. Twenty prospective cohort studies with 3756 patients (2127 obstructive sleep apnoea and 1629 non\u2010obstructive sleep apnoea) were included (9 in non\u2010cardiac surgery and 11 in cardiac surgery). Postoperative complications were almost two\u2010fold higher with obstructive sleep apnoea, OR (95%CI) 1.92 (1.52\u20132.42), p\u2009&lt;\u20090.001; certainty of evidence, moderate. Obstructive sleep apnoea was associated with a 1.5 times increased risk of postoperative cardiovascular complications, OR (95%CI) 1.56 (1.20\u20132.02), p\u2009=\u20090.001; certainty of evidence, moderate; an almost two\u2010fold increase in respiratory complications, OR (95%CI) 1.91 (1.39\u20132.62), p\u2009&lt;\u20090.001; certainty of evidence, moderate; and hospital and ICU re\u2010admission, OR (95%CI) 2.25 (1.21\u20134.19), p\u2009=\u20090.01; certainty of evidence, low. Trial sequential analysis showed adequate information size for postoperative complications. Baseline confounding factors were adjusted by meta\u2010regression, and the sub\u2010group analysis did not materially change our results. This increased risk occurred especially in patients in whom obstructive sleep apnoea had been newly diagnosed, emphasising the importance of pre\u2010operative screening.<\/jats:p>","DOI":"10.1111\/anae.15718","type":"journal-article","created":{"date-parts":[[2022,3,25]],"date-time":"2022-03-25T03:15:27Z","timestamp":1648178127000},"page":"818-828","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Postoperative outcomes in surgical patients with obstructive sleep apnoea diagnosed by sleep studies: a meta\u2010analysis and trial sequential analysis"],"prefix":"10.1111","volume":"77","author":[{"given":"B.","family":"Pivetta","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Pain Medicine University of Toronto  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Pain Medicine University of Toronto  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Nagappa","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Peri\u2010Operative Medicine, London Health Sciences Centre and St. Joseph Health Care, Schulich School of Medicine and Dentistry Western University  London ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Chinese University of Hong Kong  Hong Kong Special Administrative Region China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Englesakis","sequence":"additional","affiliation":[{"name":"Library and Information Services University Health Network  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Chung","sequence":"additional","affiliation":[{"name":"University Health Network University of Toronto  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,3,24]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI70420"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.11.069"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2016.07.002"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2008.08.007"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aes465"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000001416"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000000053"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000002344"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.3514"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2020.109731"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-013-0925-1"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aes308"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000001178"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3182009abf"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000000051"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.4783"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000000407"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.12-2905"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2018-008852"},{"key":"e_1_2_6_21_1","volume-title":"The Yale MeSH Analyzer","author":"Grossetta Nardini H","year":"2021"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e3181ee2ceb"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.15.2008"},{"key":"e_1_2_6_24_1","unstructured":"WellsG SheaB O'ConnellD et\u00a0al.The Newcastle\u2010Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta\u2010analyses.http:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp(accessed 01\/03\/2022)."},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1186"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_2_6_27_1","unstructured":"The Cochrane Collaboration. 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