OSA Shows No Effect on Atrial Fibrillation or Delirium After Cardiac Surgery

Atrial fibrillation (AF) and delirium are common complications after cardiac surgery that are associated with poorer outcomes. Researchers, led by Eva Rivas, examined if patients with obstructive sleep apnea (OSA) exhibited a higher rate of AF and delirium compared with patients without OSA after undergoing cardiac surgery.

Based on a post hoc analysis of the DECADE trial, the study’s authors concluded that preoperative OSA was not associated with a higher incidence of AF or delirium after cardiac surgery. Their findings were published in the Journal of Clinical Anesthesia.

OSA Not Linked to AF After Cardiac Surgery

The study’s primary end point was clinician diagnoses of AF or documented arrhythmia. Delirium was evaluated twice in the 5 days after surgery using the Confusion Assessment Method for the Intensive Care Unit.

The cohort included 590 patients, 133 who had OSA and 457 who did not. Researchers noted most confounders were balanced between the groups, within an absolute standardized difference <0.10 after weighting.

A total of 49 (37%) patients in the OSA group developed AF compared with 150 (33%) patients in the non-OSA group. Based on logistic regression models, the investigators concluded OSA was not associated with AF given an estimated odds ratio of 1.22 (95% CI, 0.75-1.99; P=.416).

Researchers reported 22 (17%) patients in the OSA group and 67 (15%) in the non-OSA group developed delirium. The association between OSA and delirium after cardiac surgery was also not significant at an odds ratio of 0.93 (95% CI, 0.51-1.69; P=.800)

Overall, Rivas and colleagues judged that preexisting OSA was not associated with AF or delirium in patients who underwent cardiac surgery. “These results suggest different prominent factors rather than OSA affect the incidence of these postoperative outcomes,” they closed.

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