[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 35.173.48.53. Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Views 462
Citations 0
Comment & Response
September 24, 2019

Unrecognized Obstructive Sleep Apnea in Patients Undergoing Surgery—Reply

Matthew T. V. Chan, MBBS, PhD1; Frances Chung, MBBS2; for the Postoperative Vascular Complications in Unrecognized Obstructive Sleep Apnea (POSA) Study Investigators
Author Affiliations
  • 1The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
  • 2Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
JAMA. 2019;322(12):1211-1212. doi:10.1001/jama.2019.10994

In Reply Drs Santer and Eikermann highlight previous studies reporting improved postoperative outcomes in patients with OSA.1,2 The studies used the Nationwide Inpatient Sample, which did not screen all patients for OSA, and patients with undiagnosed OSA may have been misclassified as having no OSA. Given that 11.2% of patients presenting for major noncardiac surgery in our study had severe and unrecognized OSA,3 it would not be surprising that the risk of postoperative cardiovascular complications would be heavily influenced by the percentage of patients with undiagnosed OSA in the control group. Although preconditioning has been postulated to explain better postoperative outcomes in patients with OSA in previous studies, clinical trials on ischemic preconditioning have failed to reproduce the success observed in animal studies.4

×