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Is obstructive sleep apnea associated with difficult airway? Evidence from a systematic review and meta-analysis of prospective and retrospective cohort studies

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  • Mahesh Nagappa
  • David T Wong
  • Crispiana Cozowicz
  • Satya Krishna Ramachandran
  • Stavros G Memtsoudis
  • Frances Chung

Abstract

Background: Difficult airway management and obstructive sleep apnea may contribute to increased risk of perioperative morbidity and mortality. The objective of this systematic review and meta-analysis (SRMA) is to evaluate the evidence of a difficult airway being associated with obstructive sleep apnea (OSA) patients undergoing surgery. Methods: The standard databases were searched from 1946 to April 2017 to identify the eligible articles. The studies which included adult surgical patients with either suspected or diagnosed obstructive sleep apnea must report at least one difficult airway event [either difficult intubation (DI), difficult mask ventilation (DMV), failed supraglottic airway insertion or difficult surgical airway] in sleep apnea and non-sleep apnea patients were included. Results: Overall, DI was 3.46-fold higher in the sleep apnea vs non-sleep apnea patients (OSA vs. non-OSA: 13.5% vs 2.5%; OR 3.46; 95% CI: 2.32–5.16, p

Suggested Citation

  • Mahesh Nagappa & David T Wong & Crispiana Cozowicz & Satya Krishna Ramachandran & Stavros G Memtsoudis & Frances Chung, 2018. "Is obstructive sleep apnea associated with difficult airway? Evidence from a systematic review and meta-analysis of prospective and retrospective cohort studies," PLOS ONE, Public Library of Science, vol. 13(10), pages 1-15, October.
    • Handle: RePEc:plo:pone00:0204904
    DOI: 10.1371/journal.pone.0204904
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    1. Pervin Gokay & Sevinc Tastan & Mehmet Emin Orhan, 2016. "Is there a difference between the STOP‐BANG and the Berlin Obstructive Sleep Apnoea Syndrome questionnaires for determining respiratory complications during the perioperative period?," Journal of Clinical Nursing, John Wiley & Sons, vol. 25(9-10), pages 1238-1252, May.
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