The incidence of early post-operative complications following uvulopalatopharyngoplasty: identification of predictive risk factors

Retrospective chart review.Charts of patients undergoing UPPP at an academic teaching hospital from 1999 to 2005 were reviewed.345 consecutive patients (248 inpatients; 97 outpatients) were studied. The most common post-operative complication in the entire study was oxyhemoglobin desaturation (12.8%). Three patients suffered major complications (airway obstruction, pulmonary edema, arrhythmia). Regarding complications limited to the post-anaesthetic care unit alone, only 8.2% of patients had oxyhemoglobin desaturation after discontinuation of oxygen supplementation. Inpatients requiring supplemental oxygen on the ward had significantly higher mean AHI (37.4 vs. 31.4; p=0.05) and BMI (32.3 kg/m2 vs. 28.9 kg/m2; p=0.004) than those who did not. Those inpatients who were obese (BMI > 30 kg/m2) with an AHI≥22 were associated with an increased risk of requiring oxygen on the ward (odds ratio = 3.48, 95% CI = 1.56 – 7.78).The incidence of post-UPPP complications is much lower than the literature has historically suggested. Selected patients should be able to safely undergo outpatient UPPP. Patients with higher AHI, higher BMI, or multiple comorbidities are at higher risk for postoperative complications and are most appropriate for overnight monitoring.Obstructive sleep apnea (OSA) affects 9% of males and 3% of females between the ages of 30 and 60 in the United States [1]. Untreated OSA can result in daytime hypersomnolence, hypertension, and in severe cases, cardiopulmonary failure, motor vehicle accidents, and death. Uvulopalatopharyngoplasty (UPPP) is one of the most commonly performed surgical treatments for OSA in adults, and can be combined with nasal or tongue-base procedures to give the patient a true multi-level correction. Early studies regarding UPPP outcomes demonstrated a high rate of peri- and post-operative morbidity and mortality secondary to failed intubations, arrhythmias secondary to severe apnea, hemorrhage, or upper airway obstruction, and therefore r