Bariatric surgery short-term outcomes in patients with obstructive sleep apnoea: the Severe Obesity Outcome Network prospective cohort

Aug 28, 2021International journal of obesity (2005)

Short-term results of weight-loss surgery in people with obstructive sleep apnea

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Abstract

Patients with moderate-to-severe obstructive sleep apnoea lost 64.9% of excess weight one year after bariatric surgery, compared to 73.8% in those without or with mild OSA.

Excess weight loss at one year was significantly lower in patients with moderate-to-severe obstructive sleep apnoea compared to those without or with mild OSA.
Age, initial body mass index, and type of surgery were linked to weight loss outcomes, while OSA status was not.
Remission rates for diabetes were similar in both groups, with 41% in patients with moderate-to-severe OSA and 48% in those without or with mild OSA.
Hypertension remission rates were also comparable, at 32.9% for moderate-to-severe OSA and 40.9% for no or mild OSA.
Surgical complication rates were higher in patients with moderate-to-severe OSA (13.3%) compared to those without or with mild OSA (7.5%), but this difference was not statistically significant.

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BACKGROUND/OBJECTIVES: Although the benefits of bariatric surgery have been clearly established, it is not known whether they are as important in patients with obstructive sleep apnoea (OSA). Primary aim: to evaluate whether patients with moderate-to-severe OSA (apnoea-hypopnea index (AHI) ≥ 15 events/h) treated by continuous positive airway pressure/non-invasive ventilation (median [IQR] adherence 6.5 h/night [5; 7.9] at baseline) lose the same amount of body weight 1 year after bariatric surgery as patients with no or mild OSA. Secondary objectives: to compare the evolution of type 2 diabetes and hypertension after bariatric surgery, and surgical complication rates between groups.

METHODS/SUBJECTS: Analyses were performed in 371 patients included in a prospective cohort of bariatric surgery, the Severe Obesity Outcome Network cohort. Subjects having moderate-to-severe OSA (n = 210) at baseline were compared with other subjects (n = 161).

RESULTS: Excess weight loss (%EWL) at 1 year was lower in patients with moderate-to-severe OSA than in patients without (64.9%EWL [46.9; 79.5] vs. 73.8%EWL [56.6; 89.3], p < 0.01). Multivariable analysis showed that age, initial body mass index and type of surgery, but not OSA status, were associated with 1-year %EWL. Diabetes remitted in 25 (41%) patients with moderate-to-severe OSA and 16 (48%) patients with no or mild OSA (p = 0.48). Hypertension remitted in 28 (32.9%) patients with moderate-to-severe OSA and 9 (40.9%) with no or mild (p = 0.48). Complication rates were 28 (13.3%) in patients with moderate-to-severe OSA and 12 (7.5%) in patients with no or mild OSA (p = 0.07).

CONCLUSIONS: Patients with OSA lose less body weight after bariatric surgery. This was related to older age and a higher baseline body mass index. However, the improvements of diabetes and hypertension were similar to that of patients without OSA, and the risk of surgical complications was not higher.

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Bariatric surgery short-term outcomes in patients with obstructive sleep apnoea: the Severe Obesity Outcome Network prospective cohort

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