Prevalence and prognostic factors for postoperative complications of uvulopalatopharyngoplasty in patients with obstructive sleep apnea hypopnea syndrome / 临床耳鼻咽喉头颈外科杂志

ABSTRACT

OBJECTIVE@#To explore the complication incidence and risk factors within immediate 24 hours after uvulopalatopharyngoplasty in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and provide theoretical foundation for preventing postoperative complication incidence.@*METHOD@#162 patients undergoing UPPP procedure between Mar, 2002, and Oct 2006, were analysed retrospectively. All patients were divided into two groups according to the development of postoperative complications or not. The retrospective chart review focused on the demographic data and pertinent history, preoperative sleep evaluation, surgical and anesthetic management, and need for postoperative interventions. Potential risk factors were first evaluated with univariate analysis followed by multivariate logistic regression with the occurrence of complications within immediate 24 hours after operation as the dependent variable.@*RESULT@#A total of 162 consecutive cases for UPPP were enrolled into current study. 31 cases (19.1%) had postoperative complications necessitating a medical intervention, including respiratory complications (n =21, 13.0%), cardiovascular complications (n =6, 3.7%) and hemorrhage (n =9, 5.6%). The differences in body mass index (BMI), apnea-hypopnea index (AHI), lowest oxygen saturation (LSAT) and difficult intubation were significant between two groups. Risk factors for postoperative complications were BMI (OR =1.136, 95% CI 1.007-2.558, P =0.049), preoperative AHI (OR =4.828, 95% CI 1.827-13.924, P =0.012) and difficult intubation (OR = 1.971, 95% CI 1.251- 4.839, P =0.034).@*CONCLUSION@#Baseline BMI and AHI, difficult intubation in anaesthetic procedure were the most important predictors of postsurgical morbidity. Keeping in mind the aforementioned cautionary notes, aggressively preoperative preparation should be applied for such populations to avoid the occurrence of postoperative complications.