Impact of obstructive sleep apnea-related symptoms on surgical wound complications in breast cancer patients: pilot study in a tertiary health center in Turkey

2020 
PURPOSE Wound healing is an important factor influencing morbidity following surgical procedures. The association of obstructive sleep apnea (OSA) with numerous postoperative complications has been previously reported. In this study, we report the impact of OSA-related symptoms on wound complications in breast cancer patients in the postoperative period. METHODS Breast cancer patients were enrolled for a prospective observational study. Outcome measures included sociodemographic data, self-reported sleep-wake questionnaires (Berlin questionnaire, STOP-BANG, and Epworth sleepiness scale [ESS]) as well as type of surgery, smoking status, duration of anesthesia, the need for postoperative opioid drugs, and complications for surgical wounds. Patients' general preoperative health status was quantified by using American Society of Anesthesiologists (ASA) scores. RESULTS A total of 132 women were included in the study, of whom 61% (n = 81) underwent mastectomy, and 39% (n = 51) had breast conserving surgery. Mean ESS score of the study group was 7.7 ± 0.5. Multivariant analysis identified, either being at medium high risk by STOP-BANG questionnaire (OR:1.77, p: 0.04) or being at high risk by Berlin questionnaire (OR:1.96, p: 0.04) as well as high BMI (OR:2.76 95% CI:1.73-4.65, p: 0.02), smoking history (OR:3.04 95% CI: 2.25-3.86, p: 0.01) and type of surgery (OR:2.64 95% CI: 1.63-2.89, p: 0.03) were independent factors for wound healing. CONCLUSIONS The study results suggest that patients with high risk for OSA have a tendency to develop postoperative wound complications after breast cancer surgery. This study lays groundwork for further scrutiny using more robust methodology.
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