Effective screening and treatment of obstructive sleep apnea before and after surgery may reduce the risk of post-operative delirium, according to researchers at Duke University Medical Center in Durham, N.C.
In the Duke study, 27 of 106 total knee replacement patients aged 65 years or older developed delirium after surgery. A little more than half of the patients who had been diagnosed with OSA experienced post-op delirium. However, only 20% of patients without apnea experienced delirium. Of the many medical conditions that were analyzed, OSA was the only statistically significant factor that predicted delirium, according to the researchers.
Post-op delirium is a common complication in the elderly that’s associated with increased morbidity and mortality, and has recently been associated with long-term cognitive and functional decline, notes the study.
The study’s findings, which appear in the April issue of Anesthesiology, provide early evidence that conducting better pre-surgical screening and introducing effective therapy for sleep apnea could be a way to lessen the risk of delirium, which can be a devastating adverse event, says Madan Kwatra, PhD, an associate professor of anesthesiology at Duke and the study’s lead author.
The researchers caution, however, that additional research is needed before definitively linking OSA to incidences of delirium. “Future studies may be able to further characterize the relationship between various comorbidities and post-operative delirium in the obstructive sleep apnea population,” they write.