The incidence of early post-operative complications following uvulopalatopharyngoplasty: identification of predictive risk factors
1 Department of Otolaryngology – Head & Neck Surgery, University of Western Ontario, London, ON, Canada
2 Department of Surgery, Division of Otolaryngology, University of Alberta, Edmonton, AB, Canada
3 Department of Anesthesia and Perioperative Medicine, University of Western Ontario, London, ON, Canada
4 St. Joseph’s Healthcare Centre, 268 Grosvenor St., London, ON, N6A 4V2, Canada
Journal of Otolaryngology - Head and Neck Surgery 2013, 42:15 doi:10.1186/1916-0216-42-15Published: 6 February 2013
Characterize complications following uvulopalatopharyngoplasty (UPPP) for obstructive sleep apnea.
Retrospective chart review.
Subjects and methods
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.