{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:35:01Z","timestamp":1792805701043,"version":"4.5.0"},"reference-count":85,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T00:00:00Z","timestamp":1752710400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca","award":["CIF 49997510"],"award-info":[{"award-number":["CIF 49997510"]}],"id":[{"id":"https:\/\/ror.org\/051h0cw83","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Asociatia Thoracare, Romania","award":["CIF 49997510"],"award-info":[{"award-number":["CIF 49997510"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Obstructive sleep apnea is a prevalent, yet often underdiagnosed, condition characterized by recurrent upper airway obstruction during sleep, leading to significant perioperative risks in surgical patients. This systematic review aims to evaluate the incidence and impact of objectively diagnosed obstructive sleep apnea on postoperative outcomes across various surgical specialties\u2014including bariatric, orthopedic, cardiac, and otorhinolaryngologic surgeries\u2014and to assess the effectiveness of preoperative screening and perioperative management strategies. Methods: A comprehensive literature search of PubMed was conducted for studies published between January 2013 and December 2024, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included studies involved adult surgical patients with OSA confirmed by polysomnography or respiratory polygraphy. Studies were assessed for methodological quality using the Oxford Centre for Evidence-Based Medicine Levels of Evidence framework. Results: The findings consistently indicated that obstructive sleep apnea significantly increases the risk of postoperative complications, such as respiratory depression, atrial fibrillation, acute kidney injury, delirium, and prolonged hospital stay. Continuous positive airway pressure therapy demonstrated a protective effect in bariatric and cardiac surgeries, though its effectiveness in orthopedic and otorhinolaryngologic contexts was inconsistent, largely due to adherence variability and limited implementation. Preoperative screening tools such as the STOP-BANG questionnaire were widely used, but their utility depended on integration with confirmatory diagnostics. Conclusions: Obstructive sleep apnea represents a significant, modifiable risk factor in surgical populations. Preoperative identification and risk-adapted perioperative management, including CPAP therapy and multimodal analgesia, may substantially reduce postoperative morbidity. However, further randomized trials and cost-effectiveness studies are needed to optimize care pathways and ensure consistent implementation across surgical disciplines.<\/jats:p>","DOI":"10.3390\/jcm14145095","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T14:13:43Z","timestamp":1752761623000},"page":"5095","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Impact of Obstructive Sleep Apnea in Surgical Patients: A Systematic Review"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3577-8341","authenticated-orcid":false,"given":"Ioana-Medeea","family":"Titu","sequence":"first","affiliation":[{"name":"Department of Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania"},{"name":"Department of Pneumology, Iuliu Hatieganu University of Medicine and Pharmacy, 400332 Cluj-Napoca, Romania"},{"name":"Thoracic Surgery Clinic, Leon Daniello Clinical Hospital of Pneumology, 400371 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6805-1619","authenticated-orcid":false,"given":"Damiana Maria","family":"Vulturar","sequence":"additional","affiliation":[{"name":"Department of Pneumology, Iuliu Hatieganu University of Medicine and Pharmacy, 400332 Cluj-Napoca, Romania"},{"name":"Pneumology Clinic, Leon Daniello Clinical Hospital of Pneumology, 400371 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Florica","family":"Chis","sequence":"additional","affiliation":[{"name":"Department of Pneumology, Iuliu Hatieganu University of Medicine and Pharmacy, 400332 Cluj-Napoca, Romania"},{"name":"Pneumology Clinic, Leon Daniello Clinical Hospital of Pneumology, 400371 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7686-7378","authenticated-orcid":false,"given":"Alexandru","family":"Oprea","sequence":"additional","affiliation":[{"name":"Department of Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania"},{"name":"Cardiovascular Surgery Clinic, Niculae Stancioiu Heart Institute, 400001 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandru","family":"Manea","sequence":"additional","affiliation":[{"name":"Department of Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania"},{"name":"Cardiovascular Surgery Clinic, Niculae Stancioiu Heart Institute, 400001 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1306-2350","authenticated-orcid":false,"given":"Doina Adina","family":"Todea","sequence":"additional","affiliation":[{"name":"Department of Pneumology, Iuliu Hatieganu University of Medicine and Pharmacy, 400332 Cluj-Napoca, Romania"},{"name":"Thoracic Surgery Clinic, Leon Daniello Clinical Hospital of Pneumology, 400371 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1152\/physrev.00043.2008","article-title":"Pathophysiology of sleep apnea","volume":"90","author":"Dempsey","year":"2010","journal-title":"Physiol. 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