Patients with a high risk for obstructive sleep apnea syndrome: Postoperative respiratory complications

array:25 ["pii" => "S0873215913000238" "issn" => "08732159" "doi" => "10.1016/j.rppneu.2013.01.003" "estado" => "S300" "fechaPublicacion" => "2013-07-01" "aid" => "138" "copyright" => "Sociedade Portuguesa de Pneumologia" "copyrightAnyo" => "2012" "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Rev Port Pneumol. 2013;19:144-51" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 20451 "formatos" => array:3 [ "EPUB" => 304 "HTML" => 6578 "PDF" => 13569 ] ] "itemSiguiente" => array:20 [ "pii" => "S0873215913000160" "issn" => "08732159" "doi" => "10.1016/j.rppneu.2013.01.001" "estado" => "S300" "fechaPublicacion" => "2013-07-01" "aid" => "133" "copyright" => "Sociedade Portuguesa de Pneumologia" "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Rev Port Pneumol. 2013;19:152-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 7738 "formatos" => array:3 [ "EPUB" => 255 "HTML" => 5918 "PDF" => 1565 ] ] "pt" => array:12 [ "idiomaDefecto" => true "cabecera" => "Artigo original" "titulo" => "Sonolência diurna e atenção em motoristas de ónibus urbanos de 2 capitais do Brasil" "tienePdf" => "pt" "tieneTextoCompleto" => "pt" "tieneResumen" => array:2 [ 0 => "pt" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "152" "paginaFinal" => "156" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Daytime sleepiness and attention in city bus drivers of two capitals of Brazil" ] ] "contieneResumen" => array:2 [ "pt" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "pt" => true ] "contienePdf" => array:1 [ "pt" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "D. Brasil Santos, L. Gonçalves Bittencourt, C.A. de Assis Viegas, E. Gaio" "autores" => array:4 [ 0 => array:2 [ "nombre" => "D." "apellidos" => "Brasil Santos" ] 1 => array:2 [ "nombre" => "L." "apellidos" => "Gonçalves Bittencourt" ] 2 => array:2 [ "nombre" => "C.A." "apellidos" => "de Assis Viegas" ] 3 => array:2 [ "nombre" => "E." "apellidos" => "Gaio" ] ] ] ] ] "idiomaDefecto" => "pt" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173511513000456" "doi" => "10.1016/j.rppnen.2013.06.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511513000456?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215913000160?idApp=UINPBA00004E" "url" => "/08732159/0000001900000004/v2_201509041415/S0873215913000160/v2_201509041415/pt/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0873215913000755" "issn" => "08732159" "doi" => "10.1016/j.rppneu.2013.06.002" "estado" => "S300" "fechaPublicacion" => "2013-07-01" "aid" => "162" "copyright" => "Sociedade Portuguesa de Pneumologia" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "edi" "cita" => "Rev Port Pneumol. 2013;19:142-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5424 "formatos" => array:3 [ "EPUB" => 260 "HTML" => 3945 "PDF" => 1219 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "Editorial" "titulo" => "Obstructive Sleep Apnea and Surgery: Wake up for the problem!" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "142" "paginaFinal" => "143" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Apneia Obstrutiva do Sono e Cirurgia: prestem atenção" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Geraldo Lorenzi-Filho, Pedro Rodrigues Genta, Luciano Drager" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Geraldo" "apellidos" => "Lorenzi-Filho" ] 1 => array:2 [ "nombre" => "Pedro Rodrigues" "apellidos" => "Genta" ] 2 => array:2 [ "nombre" => "Luciano" "apellidos" => "Drager" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215913000755?idApp=UINPBA00004E" "url" => "/08732159/0000001900000004/v2_201509041415/S0873215913000755/v2_201509041415/en/main.assets" ] "asociados" => array:2 [ 0 => array:19 [ "pii" => "S0873215913000755" "issn" => "08732159" "doi" => "10.1016/j.rppneu.2013.06.002" "estado" => "S300" "fechaPublicacion" => "2013-07-01" "aid" => "162" "copyright" => "Sociedade Portuguesa de Pneumologia" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "edi" "cita" => "Rev Port Pneumol. 2013;19:142-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5424 "formatos" => array:3 [ "EPUB" => 260 "HTML" => 3945 "PDF" => 1219 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "Editorial" "titulo" => "Obstructive Sleep Apnea and Surgery: Wake up for the problem!" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "142" "paginaFinal" => "143" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Apneia Obstrutiva do Sono e Cirurgia: prestem atenção" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Geraldo Lorenzi-Filho, Pedro Rodrigues Genta, Luciano Drager" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Geraldo" "apellidos" => "Lorenzi-Filho" ] 1 => array:2 [ "nombre" => "Pedro Rodrigues" "apellidos" => "Genta" ] 2 => array:2 [ "nombre" => "Luciano" "apellidos" => "Drager" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215913000755?idApp=UINPBA00004E" "url" => "/08732159/0000001900000004/v2_201509041415/S0873215913000755/v2_201509041415/en/main.assets" ] 1 => array:20 [ "pii" => "S0873215913001360" "issn" => "08732159" "doi" => "10.1016/j.rppneu.2013.08.003" "estado" => "S300" "fechaPublicacion" => "2014-01-01" "aid" => "188" "copyright" => "Sociedade Portuguesa de Pneumologia" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Rev Port Pneumol. 2014;20:50-1" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4387 "formatos" => array:3 [ "EPUB" => 244 "HTML" => 3089 "PDF" => 1054 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "Letter to the Editor" "titulo" => "Obstructive sleep apnea prevalence and adverse respiratory events in surgical patients" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "50" "paginaFinal" => "51" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Prevalência de apneia obstrutiva do sono e eventos respiratórios adversos em pacientes submetidos a cirurgia" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:2 [ 0 => array:2 [ "autoresLista" => "R. Reis" "autores" => array:1 [ 0 => array:2 [ "nombre" => "R." "apellidos" => "Reis" ] ] ] 1 => array:2 [ "autoresLista" => "A. Antunes" "autores" => array:1 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Antunes" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173511514000141" "doi" => "10.1016/j.rppnen.2013.08.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511514000141?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215913001360?idApp=UINPBA00004E" "url" => "/08732159/0000002000000001/v2_201509041402/S0873215913001360/v2_201509041402/en/main.assets" ] ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Patients with a high risk for obstructive sleep apnea syndrome: Postoperative respiratory complications" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "144" "paginaFinal" => "151" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "H. Pereira, D. Xará, J. Mendonça, A. Santos, F.J. Abelha" "autores" => array:5 [ 0 => array:3 [ "nombre" => "H." "apellidos" => "Pereira" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "D." "apellidos" => "Xará" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "J." "apellidos" => "Mendonça" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "A." "apellidos" => "Santos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 4 => array:4 [ "nombre" => "F.J." "apellidos" => "Abelha" "email" => array:2 [ 0 => "fernando.abelha@gmail.com" 1 => "abelha@me.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Department of Anesthesiology, Centro Hospitalar de São João, Porto, Portugal" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Anesthesiology and Perioperative Care Unit, Surgical Department of Medical School of Porto, Portugal" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Doentes com alto risco de Apneia Obstrutiva do Sono: complicações respiratórias pós-operatórias" ] ] "textoCompleto" => "IntroductionObstructive sleep apnea (OSA) is a common medical condition affecting 2–26% of the general population and it is the most prevalent breathing disturbance in sleep.<a class="elsevierStyleCrossRefs" href="#bib0005">1,2</a> OSA is characterized by repeated complete or partial collapse of the pharyngeal airway during sleep, causing cessation of airflow (apnoea) or shallow breathing (hypopnea). This pattern of sleep arousal, coupled with intermittent hypoxemia, is associated with serious adverse cardiovascular outcomes, including strokes, and leads to daytime somnolence and compromised neurocognitive function.<a class="elsevierStyleCrossRef" href="#bib0015">3</a>The prevalence of OSA in the surgical population is higher than in the general population and it can vary widely according to the underlying medical condition.<a class="elsevierStyleCrossRef" href="#bib0015">3</a> In particular, as many as 70% of patients undergoing bariatric surgery were found to have OSA.<a class="elsevierStyleCrossRef" href="#bib0020">4</a> OSA has been recognized as a potential independent risk factor for adverse perioperative outcome.<a class="elsevierStyleCrossRef" href="#bib0025">5</a> Compared to non-OSA patients, OSA patients undergoing surgical procedures are vulnerable to postoperative airway obstruction,<a class="elsevierStyleCrossRef" href="#bib0030">6</a> myocardial ischemia congestive heart failure, stroke and oxygen desaturation.<a class="elsevierStyleCrossRefs" href="#bib0025">5,7,8</a>The gold standard for the diagnosis of OSA, polysomnography (PSG), is impracticable as a routine preoperative assessment tool for OSA because it is an expensive and labor intensive test.<a class="elsevierStyleCrossRef" href="#bib0025">5</a> Many tools have been proposed for screening patients for OSA such as the Berlin questionnaire, the STOP questionnaire and the American Society of Anaesthesiologists (ASA) checklist – and the use of these tools improves the likelihood of identifying OSA preoperatively.<a class="elsevierStyleCrossRef" href="#bib0015">3</a> The STOP questionnaire, showed a high sensitivity for detecting OSA (when score is ≥3): 93% and 100% for moderate and severe OSA, respectively; however, the specificity at the same cut-off is low: 47% and 37% for moderate and severe OSA, respectively, resulting in high false-positive rates. The STOP questionnaire is a scoring model consisting of 8 easily administrated questions starting with the acronym STOP-BANG (<a class="elsevierStyleCrossRef" href="#sec0065">Appendix</a>) and is scored based on Yes/No answers (scores 1/0).<a class="elsevierStyleCrossRef" href="#bib0005">1</a>The aim of this study was to evaluate the incidence of patients with a STOP-BANG score≥3, in surgical patients admitted in the Post-Anesthesia Care Unit (PACU).MethodsSubjects and settingsEthical approval for this study was provided by the Ethics Committee of Centro Hospitalar São João, Porto, Portugal. Written informed consent was obtained from all participants.Centro Hospitalar São João, Porto, is an 1124-bed tertiary hospital in a major metropolitan area that serves 3,000,000 people. This prospective study was conducted in a 12-bed PACU over a 3-week period (from May 9th to May 27th, 2011). Every patient admitted to the PACU who was able to provide written informed consent was included in the study. Exclusion criteria were patient refusal, incapacity to provide informed consent, a score of <25 in the mini-mental state examination (MMSE), under 18 years of age, foreign nationality, known neuromuscular disease, urgent/emergent surgery and cardiac surgery, neurosurgery or other procedures that required therapeutic hypothermia.All the patients were asked to complete the STOP questionnaire. Information concerning body mass index (BMI) age, neck circumference, and gender (Bang) were collected by a research assistant.Patients were classified as being at high risk for obstructive sleep apnea (HR-OSA) if their STOP-BANG score was 3 or greater and as being at low risk of OSA (LR-OSA) if their score was less than 3.The anesthesiologist in charge was blinded to patient involvement in the study. Anesthesia was provided and monitored according to the anesthesiologist in charge criteria, but this conduct followed minimum departmental standards. Neuromuscular blocking drugs (NMBD) were used for tracheal intubation, and additional boluses were provided, if needed. No written policy exists concerning the use of neuromuscular monitoring so this was performed at the discretion of the anesthesiologist. To ensure that the anesthesiologist remained blinded to the patients’ participation in the study, we did not attempt to observe the use or interpretation of TOF intraoperatively. The anesthesiologist was free to decide whether to reverse the neuromuscular blockade (NMB) with neostigmine at the conclusion of the surgical procedure.Usually, the patient was extubated in the operating room and transferred to the PACU. Criteria for extubation included sustained head lift or hand grip for more than 5s, the ability to follow simple commands, a stable ventilatory pattern with acceptable arterial oxygen saturation (SpO2)>95%, and a TOF ratio greater than 0.80. All subjects were administered 100% oxygen by a facemask after tracheal extubation. The anesthesiologist was free to decide whether to administer oxygen during the time between transfer to the cart and admission to the PACU.Upon arrival at the PACU all subjects were provided with oxygen either by a nasal cannula or face mask.A standardized data collection sheet was completed for each patient. The recorded patient characteristics were: age, weight, height, body mass index (BMI), benzodiazepine administration before surgery, chronic benzodiazepine use, site of surgery (intra-abdominal, musculoskeletal or head and neck), American Society of Anesthesiologists physical status (ASA-PS), Revised Cardiac Risk Index (RCRI), drug or alcohol abuse, duration of preoperative fluid fasting, type of anesthesia, duration of surgery, use of nitrous oxide, adverse respiratory events in the PACU, postoperative pain level (VAS score), postoperative nausea and vomiting 6hours after surgery and 24h after surgery, length of stay in the PACU, and postoperative length of stay in hospital.The surgical procedure was classified in terms of magnitude, as major (surgery in which body cavities or major vessels are exposed to ambient temperature such as major abdominal, thoracic, or major vascular, thoracic spine surgery with instrumentation, or hip arthroplasty), medium (surgery in which body cavities are exposed to a lesser degree such as appendectomy), and minor surgery (superficial surgery). Major surgery was defined as a surgery requiring a hospital stay of 2 or more days.Clinical risk factors (a history of ischemic heart disease, history of compensated or prior heart failure, history of cerebrovascular disease, diabetes mellitus, and renal insufficiency) and surgical risk (high-risk defined as intrathoracic, intraperitoneal, or suprainguinal vascular surgery, or surgery involving large blood loss or fluid shifts) were defined according to the Cardiac Risk Stratification for Noncardiac Surgical Procedures of the 2007 guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.<a class="elsevierStyleCrossRef" href="#bib0045">9</a>Data for other preoperative clinical information regarding chronic obstructive pulmonary disease (COPD), hypertension and dyslipidemia were collected from routine clinical documentation entered into the institution's perioperative clinical information system.Residual neuromuscular blocking was defined as a TOF<0.9 and it was quantified at admission to the PACU using acceleromyography of the adductor pollicis muscle (TOF-Watch®).<a class="elsevierStyleCrossRefs" href="#bib0050">10,11</a>The patients were screened for delirium at PACU discharge and in the ward the next day after surgery using the nursing delirium screening scale (Nu-DESC).<a class="elsevierStyleCrossRef" href="#bib0060">12</a> Patients with a Nu-DESC score of 2 or more points during at least at 1 evaluation were considered delirium positive. Patients were tested for delirium by the research team at the time they were formally declared to be ‘ready for discharge’ to the regular ward by the physician in charge of the recovery room. In addition, the patients were seen on the morning of the first postoperative day.Postoperative respiratory complicationsEach postoperative ARE was defined on the data collection sheet using the following criteria according to the classification described by Murphy et al<a class="elsevierStyleCrossRef" href="#bib0065">13</a>:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005">1.Upper airway obstruction requiring an intervention (jaw thrust, or oral or nasal airway);</li><li class="elsevierStyleListItem" id="lsti0010">2.Mild-moderate hypoxia (SpO2 of 93–90%) on 3L nasal cannula O2 that was not improved after active interventions (increasing O2 flows to >3L/min, application of high-flow face mask O2, verbal requests to breathe deeply and tactile stimulation);</li><li class="elsevierStyleListItem" id="lsti0015">3.Severe hypoxia (SpO2<90%) on 3L nasal cannula O2 that was not improved after active interventions (increasing O2 flows to >3L/min, application of high-flow facemask O2, verbal requests to breathe deeply, and tactile stimulation);</li><li class="elsevierStyleListItem" id="lsti0020">4.Signs of respiratory distress or impending ventilatory failure (respiratory rate >20 breaths per minute, accessory muscle use, and tracheal tug);</li><li class="elsevierStyleListItem" id="lsti0025">5.Inability to breathe deeply when requested to by the PACU nurse;</li><li class="elsevierStyleListItem" id="lsti0030">6.Patient complaining of symptoms of respiratory or upper airway muscle weakness (difficulty breathing, swallowing, or speaking);</li><li class="elsevierStyleListItem" id="lsti0035">7.Patient requiring reintubation in the PACU;</li><li class="elsevierStyleListItem" id="lsti0040">8.Clinical evidence or suspicion of pulmonary aspiration after tracheal extubation (gastric contents observed in the oropharynx and hypoxemia).</li></ul>The PACU nurses observed the patients continuously during the PACU stay and contacted a study investigator immediately if an ARE was observed. The inability to breathe deeply and the assessment of symptoms of respiratory or upper airway muscle weakness were assessed at 10-minute intervals. A study investigator examined the patient to confirm that the patient met at least one of the criteria for an ARE.Statistical methodDescriptive analysis of variables was used to summarize data. Ordinal and continuous data found not to follow a normal distribution, based on the Kolmogorov–Smirnov test for normality of the underlying population, are presented as median and interquartile range. Normally distributed data are presented as mean and standard deviation (SD).A univariate analysis was performed to identify differences between HR-OSA and LR-OSA patients by using the Mann–Whitney U-test to compare continuous variables and the Chi-square or Fisher's exact test to compare proportions between the 2 groups of subjects. Differences were considered statistically significant when P was <0.05.A univariate analysis was performed to identify predictors for ARE.Multiple regression binary logistic was used with forward conditional method in the model in order to identify independent predictors for ARE. In this model, all covariates with p<0.05 in the univariate analyses were entered and an odds ratio (OR) and 95% Confidence Interval (95% CI) were calculated.Data were analyzed using SPSS software for Windows Version 19.0 (SPSS Inc., Chicago, IL, USA).ResultsFrom the 357 patients consecutively admitted to the PACU during the study period, a total of 340 patients were studied. Seventeen patients were excluded: 7 patients were admitted to a surgical intensive care unit, 3 patients were unable to provide informed consent or had a MMSE <25, 3 patients did not undergo surgery, 1 patient underwent neurosurgery, 1 patient was less than 18 years old, 1 patient did not speak Portuguese and 1 patient refused to participate.Of the 340 patients included in the analysis (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>), 179 (52%) were classified as HR-OSA. These patients were older (mean age of 61.7±13.4 vs. 48.8±16.0 years and median age 63 vs. 47 years, p<0.001), were more likely to be men (63% vs. 21%, p<0.001), had higher BMI (mean 29.1±6.0 vs. 25.1±4.4kg/m2, median 28 vs. 24kg/m2, p<0.001) higher ASA physical status (ASA III, IV or V 26% vs. 10%, p<0.001) and higher RCRI scores (RCRI>2 in 7% vs. 2%). Patients with HR-OSA had a higher incidence of ischemic heart disease (10% vs. 2%, p=0.001), heart failure (8% vs. 3%, p=0.032), hypertension (62% vs. 19%, p<0.001), dyslipidemia (41% vs. 12%, p<0.001) and underwent more frequently insulin treatment for diabetes (24% vs. 4%, p<0.001). The prevalence of cerebrovascular disease (4% vs. 1%, p=0.116) and preoperative serum creatinine >2mg/dl (6% vs. 4%, p=0.394) were not significantly different between the 2 groups.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>HR-OSA patients were more likely to undergo intra-abdominal surgery (43% vs. 29%, p=0.011) and surgery of major magnitude (32% vs. 22%, p=0.033), had more frequently loco regional anesthesia as a unique technique (26% vs. 14%, p=0.009) and less frequently had general or combined general and loco regional anesthesia (74% vs. 86%, p=0.009). Patients classified as HR-OSA had a higher incidence of residual NMB (RNMB) (20% vs. 16%, p=0.035).In relation to respiratory events (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>) that occurred in the PACU, HR-OSA patients had more frequently experienced mild/moderated hypoxia (9% vs. 3%, p=0.012). The length of the hospital stay (median 5 days vs. 3 days, p=0.01), but not the length of the PACU stay (96 vs. 91minutes, p=0.064), was higher in these patients.<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>In multivariate analyses for ARE occurrence (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>) and after adjustment for univariate predictors (gender, intra-abdominal surgery, major surgery, cardiovascular high-risk surgery, general anesthesia and/or combined anesthesia, use of neuromuscular relaxants and postoperative residual neuromuscular blockade) the occurrence of residual neuromuscular blockade was identified as an independent predictor of ARE.<elsevierMultimedia ident="tbl0015"></elsevierMultimedia>In these analyses HR-OSA was not a determinant for ARE (p=0.142) and was not entered in the multivariate model. HR-OSA is shown in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> but it was not introduced in the model because it was not considered determinant for ARE.DiscussionThe incidence of patients with HR-OSA was 52% in our study, which indicates that this is an important matter for concern among patients scheduled for surgery in our hospital.We relied on a STOP-BANG score≥3 for this study, since this was demonstrated to be a highly sensitive test for moderate/severe OSA. Indeed, Chung et al.<a class="elsevierStyleCrossRef" href="#bib0070">14</a> suggested that this cut-off is appropriate for the surgical population<a class="elsevierStyleCrossRef" href="#bib0070">14</a> and further stated that the STOP-BANG questionnaire is concise, easy to use, and its importance lies in the identification of patients at high risk of OSA which may help to prevent postoperative complications.The HR-OSA group of patients had a significantly higher percentage of men and as expected the BMI was significantly different between the LR-OSA and HR-OSA groups (p<0.001). Similar results have been reported previously.<a class="elsevierStyleCrossRefs" href="#bib0075">15,16</a> The importance of these findings is revealed by the presence of these variables in different tools such as the sleep apnea clinical score (SACS) and even the STOP-BANG, used to assess OSA severity.The association between increased morbidity and untreated OSA is well established, which may result in an increased mortality rate.<a class="elsevierStyleCrossRefs" href="#bib0085">17,18</a> Furthermore, these patients are at a greater risk of developing cardiovascular disease. Indeed, HR-OSA patients had more frequently cardiac comorbidities (ischemic heart disease and congestive heart failure), hypertension, dyslipidaemia and pulmonary chronic disease in our study. These comorbidities may, however, have reflected higher ASA and RCRI scores, which would indirectly indicate the presence of more important associated comorbidities in patients at a higher risk of having OSA.Our results show that HR-OSA patients more frequently underwent bariatric surgery, abdominal surgery, and major surgery. Thus, it is possible that the risks associated with major surgery and bariatric surgery may account for the higher complication rates rather than the diagnosis of HR-OSA in itself.We found that the length of the hospital stay was higher in HR-OSA patients, which is in agreement with the study of Liu et al.<a class="elsevierStyleCrossRef" href="#bib0095">19</a> This suggests postoperative hypoxemia is associated with adverse outcomes including the need for more frequent respiratory interventions and more intensive monitoring which may led to a longer hospital stayThe incidence of RNMB was higher in HR-OSA patients. In addition, a higher incidence of RNMB was found in patients with a high BMI,<a class="elsevierStyleCrossRefs" href="#bib0100">20,21</a> which may be due to the accumulation of neuromuscular blocker in the adipose tissue. These data suggest that enhanced monitoring is important when HR-OSA patients are exposed to additional risk factors for respiratory complications like RNMB, or when these patients are given drugs that enhance neuromuscular blockade.Perioperative complications, including respiratory events, were more frequent in patients with HR-OSA. Compared with patients without this diagnosis, we found that the HR-OSA patients more frequently experienced mild/moderated hypoxia in the PACU and there was a greater risk of postoperative hypoxemia in HR-OSA patients in comparison with those without the diagnosis. This is consistent with the results of the study of Gali et al.,<a class="elsevierStyleCrossRef" href="#bib0075">15</a> which found that respiratory events were more frequent in patients with a high risk of OSA. However, in our study, as in the study of Chung et al.<a class="elsevierStyleCrossRef" href="#bib0110">22</a> analysis of perioperative adverse events did not show significant respiratory morbidity in HR-OSA patients compared to the LR-OSA patients. In fact in our study we did not find that HR-OSA was a determinant for ARE.This study has several limitations. The first and most important limitation is that it was not possible to compare the results of the STOP-BANG questionnaire with a definitive polysomnographic diagnosis.Second, our patients may have been at high risk for postoperative events without having OSA. The use of the STOP-BANG score is as an instrument to predict the risk of a patient to having OSA may have led to a high incidence of false positive results. It is possible that a higher score should have been used because recent studies have shown that the STOP-BANG score has a higher accuracy in detecting moderate to severe OSA patients in a surgical population when the score is greater than or equal to 5.<a class="elsevierStyleCrossRef" href="#bib0005">1</a>Third, the respiratory events were only registered in the PACU and complications that could have occurred after PACU discharge were not considered. This might be viewed as a major limitation since respiratory complications after surgery may be associated with adverse outcomes that occur during the hospital stay after PACU discharge.Fourth, the fact that HR-OSA patients more frequently underwent major surgery may be viewed as a confounding factor and a limitation of the study because it indicates that the patient groups were non-homogeneous.In conclusion, the principal findings of this study are as follows:<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0045">-HR-OSA patients have a higher incidence of postoperative respiratory complications;</li><li class="elsevierStyleListItem" id="lsti0050">-mild/moderate hypoxia was the most frequent pulmonary adverse event in the immediate postoperative period that occurred more frequently in HR-OSA patients;</li><li class="elsevierStyleListItem" id="lsti0055">-HR-OSA patients had more comorbidities including ischemic heart disease, congestive heart failure, diabetes treated with insulin, chronic pulmonary disease, hypertension and dyslipidemia;</li><li class="elsevierStyleListItem" id="lsti0060">-HR-OSA patients required a longer stay in the hospital.</li><li class="elsevierStyleListItem" id="lsti0065">-HR-OSA was not a determinant for ARE.</li></ul>Ethical disclosuresProtection of human and animal subjectsThe authors declare that no experiments were performed on humans or animals for this study.Confidentiality of dataThe authors declare that they have followed the protocols of their work center on the publication of patient data and that all the patients included in the study received sufficient information and gave their written informed consent to participate in the study.Right to privacy and informed consentThe authors have obtained the written informed consent of the patients or subjects mentioned in the article. The corresponding author is in possession of this document.Conflicts of interestThe authors have no conflicts of interest to declare." "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres547728" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec565608" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres547729" "titulo" => "Resumo" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introdução" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusões" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec565609" "titulo" => "Palavras-chave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Methods" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Subjects and settings" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Postoperative respiratory complications" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Statistical method" ] ] ] 6 => array:2 [ "identificador" => "sec0030" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0035" "titulo" => "Discussion" ] 8 => array:3 [ "identificador" => "sec0040" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0045" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0050" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0055" "titulo" => "Right to privacy and informed consent" ] ] ] 9 => array:2 [ "identificador" => "sec0060" "titulo" => "Conflicts of interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2012-10-03" "fechaAceptado" => "2013-01-30" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec565608" "palabras" => array:4 [ 0 => "Obstructive sleep apnea" 1 => "STOP-BANG score" 2 => "Surgery" 3 => "Postoperative complications" ] ] ] "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec565609" "palabras" => array:4 [ 0 => "Apneia obstrutiva do sono" 1 => "Pontuação STOP-BANG" 2 => "Cirurgia" 3 => "Complicações pós-operatórias" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "BackgroundSTOP-BANG score (snore; tired; observed apnea; arterial pressure; body mass index; age; neck circumference and gender) can predict the risk of a patient having Obstructive Syndrome Apnea (OSA). The aim of this study was to evaluate the incidence STOP-BANG score≥3, in surgical patients admitted to the Post-Anesthesia Care Unit (PACU). MethodsObservational, prospective study conducted in a post-anesthesia care unit (PACU) during three weeks (2011). The study population consisted of adult patients after noncardiac and non-neurological surgery. Patients were classified as high risk of OSA (HR-OSA) if STOP-BANG score≥3 and Low-risk of OSA (LR-OSA) if STOP-BANG score<3 (LR-OSA). Patient demographics, intraoperative and postoperative data were collected. Patient characteristics were compared using Mann–Whitney U-test, t-test for independent groups, and chi-square or Fisher's exact test. ResultsA total of 357 patients were admitted to PACU; 340 met the inclusion criteria. 179 (52%) were considered HR-OSA. These patients were older, more likely to be masculine, had higher BMI, higher ASA physical status, higher incidence of ischemic heart disease, heart failure, hypertension, dyslipidemia and underwent more frequently insulin treatment for diabetes. These patients had more frequently mild/moderated hypoxia in the PACU (9% vs. 3%, p=0.012) and had a higher incidence of residual neuromuscular blockade (NMB) (20% vs. 16%, p=0.035). Patients with HR-OSA had a longer hospital stay. ConclusionsPatients with HR-OSA had an important incidence among patients scheduled for surgery in our hospital. These patients had more co-morbidities and were more prone to post-operative complications." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "pt" => array:3 [ "titulo" => "Resumo" "resumen" => "IntroduçãoA pontuação no STOP-BANG (Snore, Tired, Observed apnea, blood Pressure) pode prever o risco de um doente ter Síndrome da Apneia Obstrutiva Sono (SAOS). O objetivo deste estudo foi avaliar a incidência da pontuação STOP BANG> 3, em pacientes cirúrgicos internados na Unidade de Cuidados Pós-Anestésica (UCPA). MétodosEstudo observacional e prospectivo conduzido numa UCPA, durante três semanas (2011). A população de estudo consistiu em doentes adultos após cirurgia não cardíaca e não neurológica. Os doentes foram considerados com alto risco de SAOS (AR-SAOS) se tinham um score de STOP-BANG ≥3 e de baixo risco de SAOS (BR-SAOS) se tinham score de STOP-BANG <3. Foram avaliados dados demográficos dos doentes e colhidas variáveis intraoperatórias e pós-operatórias. As características dos doentes foram comparadas através do teste de Mann-Whitney, teste t, qui-quadrado ou teste exato de Fisher. ResultadosUm total de 357 doentes foram admitidos de UCPA e 340 preencheram os critérios de inclusão. Cento e setenta e nove (52%) tinham AR-SAOS. Estes doentes eram mais velhos, tinham maior probabilidade de serem do sexo masculino, tinham um Índice Massa Corporal superior, tiveram uma classificação maior no estado físico American Society Anesthesiologists, uma maior incidência de doença cardíaca isquémica, insuficiência cardíaca, hipertensão, dislipidemia e eram mais frequentemente doentes com diabetes em tratamento com insulina. Esses doentes tiveram mais frequentemente hipóxia leve/moderado na UCPA (9% versus 3%, P=0,012) e tiveram maior incidência de bloqueio neuromuscular residual (NMB) (20% versus 16%, P=0,035). Os doentes com AR-SAOS tiveram maior tempo de internamento hospitalar. ConclusõesOs doentes com AR-SAOS tem uma alta incidência entre os doentes submetidos a intervenções cirúrgicas programadas no nosso hospital. Esses doentes tinham mais comorbilidades e foram mais propensos a ter complicações pós-operatórias." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introdução" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusões" ] ] ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<elsevierMultimedia ident="fig0005"></elsevierMultimedia>" "etiqueta" => "Appendix A" "titulo" => "STOP-Bang Scoring Model" "identificador" => "sec0065" ] ] ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">HR-OSA (n=179) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">LR-OSA n=161 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Age, median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">63 (55–71) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">47 (36–61) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001<a class="elsevierStyleCrossRef" href="#tblfn0015">c</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Gender, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">113 (63) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33 (21) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">66 (37) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">128 (80) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top">Site of Surgery, n (%)</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Intraabdominal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">76 (43) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">47 (29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.011<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Musculoskeletal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">88 (49) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">91 (57) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.175<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Head and Neck \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15 (8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23 (14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.084<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Body mass index (kg/m2), median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28 (25–32) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24 (22–28) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001<a class="elsevierStyleCrossRef" href="#tblfn0015">c</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">ASA physical status, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">I/II \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">132 (74) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">145 (90) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">III/IV/V, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">47 (26) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16 (10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">High risk surgery, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">57 (32) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">36 (22) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.050<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Ischemic heart disease, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18 (10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.001<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Congestive heart disease, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15 (8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.032<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Cerebrovascular disease, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 (4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.116<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Insulin therapy for diabetes, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">42 (24) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 (4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Renal insufficiency, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 (6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 (4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.394<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">RCRI, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.030<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">RCRI≤2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">167(93) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">158 (98) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">RCRI>2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12 (7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Hypertension, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">111(62) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30 (19) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Dyslipidemia, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">73(41) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">19 (12) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">COPD, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15 (8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.015<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Type of anesthesia, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.009<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Loco regional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">46 (26) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23 (14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">General/combined \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">133 (74) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">138 (86) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top">Magnitude of surgery, n (%)</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Minor \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 (8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21 (13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.114<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Medium \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">108 (63) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">104 (65) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.481<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Major \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">57 (32) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">36 (22) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.033<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Bariatric surgery, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12 (7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.016<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Duration surgery, median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">87 (50–135) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">75 (50–120) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.173<a class="elsevierStyleCrossRef" href="#tblfn0015">c</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Post-operative delirium hospital, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23 (13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16 (10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.400<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Temperature on admission, median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">35.3 (34.9–35.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">35.4 (34.9–35.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.158<a class="elsevierStyleCrossRef" href="#tblfn0015">c</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><35°C, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">104 (33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.424<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Length of PACU stay minutes, median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">96 (67–145) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">91 (65–120) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.064<a class="elsevierStyleCrossRef" href="#tblfn0015">c</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Length of Hospital stay (days), median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (2–8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (2–6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.010<a class="elsevierStyleCrossRef" href="#tblfn0015">c</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Perioperative muscle relaxants use, n(%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">99 (55) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">106 (66) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.048<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Neuromuscular residual blocking, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">35(20) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25 (16) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.035<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab884679.png" ] ] ] "notaPie" => array:3 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "Pearson's chi-squared test." ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "Fisher's exact test." ] 2 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "c" "nota" => "Mann–Whitney U-test IQR, interquartile range HR-OSA, high-risk of OSA; ASA, American Society of Anesthesiologists; RCRI, revised cardiac risk index; COPD, Chronic Pulmonary Obstructive Disease; PACU, Post Anesthesia Care Unit." ] ] ] "descripcion" => array:1 [ "en" => "Patient baseline characteristics (n=340)." ] ] 1 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">All (n=340) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">HR-OSA n=179 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">LR-OSA n=161 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Respiratory events \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">64 (19) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">39 (22) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25 (16) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.140 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Obstruction airway \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.475 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Hypoxia (mild/moderate) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">19 (6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15 (9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.012 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Hypoxia Severe \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2(1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.529 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Respiratory failure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2(1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.253 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Inspiratory capacity decreased \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">49(15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21 (13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.407 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Muscle weakness \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11 (3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 (5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.132 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab884681.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Respiratory complications (n=340)." ] ] 2 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Simple OR (95% CI) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><a class="elsevierStyleCrossRef" href="#tblfn0025">b</a>OR (95% CI) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p<a class="elsevierStyleCrossRef" href="#tblfn0020">a</a> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Gender \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.9 (1.0–3.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.038 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Intra-abdominal surgery \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.8 (1.0–3.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.049 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">General/combined anesthesia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.9 (1.3– 6.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.013 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">NMBD use \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.8 (1.5–5.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.002 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">RNMB \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.1 (3.1 –12.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5.9 (2.8–12.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">High risk surgery \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.3 (1.3–4.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.004 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Major surgery \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.8 (1.0–3.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.045 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">HR-OSA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.5 (0.9–2.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.145 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab884680.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0020" "etiqueta" => "a" "nota" => "Logistic regression analysis with forward conditional elimination method was used with an entry criterion of p<0.05. OR; odds ratio; CI, Confidence Interval; NMBD, neuromuscular blocking drugs; RNMB, residual neuromuscular blockade." ] 1 => array:3 [ "identificador" => "tblfn0025" "etiqueta" => "b" "nota" => "Adjusted OR for gender, intra-abdominal surgery, high-risk surgery, major surgery, NMBD use and RNMB (variables considered to be determinants for ARE in a univariate analyses)." ] ] ] "descripcion" => array:1 [ "en" => "Multivariate regression analysis for predictors of adverse respiratory events." ] ] 3 => array:5 [ "identificador" => "fig0005" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "fx1.jpeg" "Alto" => 3660 "Ancho" => 3334 "Tamanyo" => 500994 ] ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:22 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "High STOP-Bang score indicates a high probability of obstructive sleep apnoea" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "F. Chung" 1 => "R. Subramanyam" 2 => "P. Liao" 3 => "E. Sasaki" 4 => "C. Shapiro" 5 => "Y. Sun" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/bja/aes022" "Revista" => array:7 [ "tituloSerie" => "Br J Anaesth" "fecha" => "2012" "volumen" => "108" "paginaInicial" => "768" "paginaFinal" => "775" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22401881" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0140673601061025" "estado" => "S300" "issn" => "01406736" ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "STOP questionnaire—a tool to screen patients for obstructive sleep apnea" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "F. Chung" 1 => "B. Yegneswaran" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Anesthesiology" "fecha" => "2008" "volumen" => "V" "paginaInicial" => "812" "paginaFinal" => "821" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Perioperative management of obstructive sleep apnea: ready for prime time?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S. Shafazand" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3949/ccjm.76.s4.16" "Revista" => array:7 [ "tituloSerie" => "Cleve Clin J Med" "fecha" => "2009" "volumen" => "76" "numero" => "Suppl." "paginaInicial" => "S98" "paginaFinal" => "S103" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19880843" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Interactions between obesity and obstructive sleep apnea: implications for treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Romero-Corral" 1 => "S.M. Caples" 2 => "F. Lopez-Jimenez" 3 => "V.K. Somers" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1378/chest.09-0360" "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "2010" "volumen" => "137" "paginaInicial" => "711" "paginaFinal" => "719" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20202954" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Risk assesment of obstructive sleep apnea in a population of patients undergoing ambulatory surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L. Tracey" 1 => "C. Wright" 2 => "A. George" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "J Clin Sleep Med" "fecha" => "2010" "volumen" => "6" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Risk assessment of obstructive sleep apnea in a population of patients undergoing ambulatory surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "T.L. Stierer" 1 => "C. Wright" 2 => "A. George" 3 => "R.E. Thompson" 4 => "C.L. Wu" 5 => "N. Collop" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Clin Sleep Med" "fecha" => "2010" "volumen" => "6" "paginaInicial" => "467" "paginaFinal" => "472" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20957847" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long-term cardiovascular outcomes in men with obstructive sleep apnoea–hypopnoea with or without treatment with continuous positive airway pressure: an observational study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.M. Marin" 1 => "S.J. Carrizo" 2 => "E. Vicente" 3 => "A.G. Agusti" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(05)71141-7" "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "2005" "volumen" => "365" "paginaInicial" => "1046" "paginaFinal" => "1053" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15781100" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Obstructive sleep apnea of obese adults: pathophysiology and perioperative airway management" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S. Isono" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/ALN.0b013e31819c74be" "Revista" => array:6 [ "tituloSerie" => "Anesthesiology" "fecha" => "2009" "volumen" => "110" "paginaInicial" => "908" "paginaFinal" => "921" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19293689" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery): developed in collaboration with the American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, and Society for Vascular Surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L.A. Fleisher" 1 => "J.A. Beckman" 2 => "K.A. Brown" 3 => "H. Calkins" 4 => "E. Chaikof" 5 => "K.E. Fleischmann" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIRCULATIONAHA.107.185699" "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "2007" "volumen" => "116" "paginaInicial" => "e418" "paginaFinal" => "e499" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17901357" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Residual neuromuscular block: lessons unlearned. Part I: Definitions, incidence, and adverse physiologic effects of residual neuromuscular block" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "G.S. Murphy" 1 => "S.J. Brull" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1213/ANE.0b013e3181da832d" "Revista" => array:6 [ "tituloSerie" => "Anesth Analg" "fecha" => "2010" "volumen" => "111" "paginaInicial" => "120" "paginaFinal" => "128" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20442260" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Residual neuromuscular blockade: incidence, assessment, and relevance in the postoperative period" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "G.S. Murphy" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Minerva Anestesiol" "fecha" => "2006" "volumen" => "72" "paginaInicial" => "97" "paginaFinal" => "109" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16493386" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fast, systematic, and continuous delirium assessment in hospitalized patients: the nursing delirium screening scale" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.D. Gaudreau" 1 => "P. Gagnon" 2 => "F. Harel" 3 => "A. Tremblay" 4 => "M.A. Roy" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jpainsymman.2004.07.009" "Revista" => array:6 [ "tituloSerie" => "J Pain Symptom Manage" "fecha" => "2005" "volumen" => "29" "paginaInicial" => "368" "paginaFinal" => "375" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15857740" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Residual neuromuscular blockade and critical respiratory events in the postanesthesia care unit" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "G.S. Murphy" 1 => "J.W. Szokol" 2 => "J.H. Marymont" 3 => "S.B. Greenberg" 4 => "M.J. Avram" 5 => "J.S. Vender" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1213/ane.0b013e31816d1268" "Revista" => array:6 [ "tituloSerie" => "Anesth Analg" "fecha" => "2008" "volumen" => "107" "paginaInicial" => "130" "paginaFinal" => "137" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18635478" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "High STOP-Bang score indicates a high probability of obstructive sleep apnoea" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "F. Chung" 1 => "R. Subramanyam" 2 => "P. Liao" 3 => "E. Sasaki" 4 => "C. Shapiro" 5 => "Y. Sun" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/bja/aes022" "Revista" => array:7 [ "tituloSerie" => "Br J Anaesth" "fecha" => "2012" "volumen" => "108" "paginaInicial" => "768" "paginaFinal" => "775" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22401881" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0140673699065277" "estado" => "S300" "issn" => "01406736" ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Identification of patients at risk for postoperative respiratory complications using a preoperative obstructive sleep apnea screening tool and postanesthesia care assessment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "B. Gali" 1 => "F.X. Whalen" 2 => "D.R. Schroeder" 3 => "P.C. Gay" 4 => "D.J. Plevak" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/ALN.0b013e31819b5d70" "Revista" => array:7 [ "tituloSerie" => "Anesthesiology" "fecha" => "2009" "volumen" => "110" "paginaInicial" => "869" "paginaFinal" => "877" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19293694" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0016508509001656" "estado" => "S300" "issn" => "00165085" ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Derivation and validation of a simple perioperative sleep apnea prediction score" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.K. Ramachandran" 1 => "S. Kheterpal" 2 => "F. Consens" 3 => "A. Shanks" 4 => "T.M. Doherty" 5 => "M. Morris" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1213/ANE.0b013e3181d489b0" "Revista" => array:6 [ "tituloSerie" => "Anesth Analg" "fecha" => "2010" "volumen" => "110" "paginaInicial" => "1007" "paginaFinal" => "1015" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20357144" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A systemic review of obstructive sleep apnea and its implications for anesthesiologists" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.A. Chung" 1 => "H. Yuan" 2 => "F. Chung" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1213/ane.0b013e318187c83a" "Revista" => array:6 [ "tituloSerie" => "Anesth Analg" "fecha" => "2008" "volumen" => "107" "paginaInicial" => "1543" "paginaFinal" => "1563" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18931212" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association of sleep apnoea with myocardial infarction in men" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Hung" 1 => "E.G. Whitford" 2 => "R.W. Parsons" 3 => "D.R. Hillman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "1990" "volumen" => "336" "paginaInicial" => "261" "paginaFinal" => "264" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1973968" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Postoperative hypoxemia in orthopedic patients with obstructive sleep apnea" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.S. Liu" 1 => "M.F. Chisholm" 2 => "J. Ngeow" 3 => "R.S. John" 4 => "P. Shaw" 5 => "Y. Ma" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11420-010-9165-0" "Revista" => array:6 [ "tituloSerie" => "Hss J" "fecha" => "2011" "volumen" => "7" "paginaInicial" => "2" "paginaFinal" => "8" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22294951" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0100" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reversal from non-depolarising neuromuscular blockade in the postoperative period" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "T. Gaszynski" 1 => "L. Szlachcinski" 2 => "J. Jakubiak" 3 => "W. Gaszynski" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Anestezjol Intens Ter" "fecha" => "2009" "volumen" => "41" "paginaInicial" => "11" "paginaFinal" => "15" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19517671" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0105" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Randomized comparison of sugammadex and neostigmine for reversal of rocuronium-induced muscle relaxation in morbidly obese undergoing general anaesthesia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "T. Gaszynski" 1 => "T. Szewczyk" 2 => "W. Gaszynski" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/bja/aer330" "Revista" => array:6 [ "tituloSerie" => "Br J Anaesth" "fecha" => "2012" "volumen" => "108" "paginaInicial" => "236" "paginaFinal" => "239" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22012861" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0110" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Preoperative identification of sleep apnea risk in elective surgical patients, using the Berlin questionnaire" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "F. Chung" 1 => "B. Ward" 2 => "J. Ho" 3 => "H. Yuan" 4 => "L. Kayumov" 5 => "C. Shapiro" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jclinane.2006.08.006" "Revista" => array:6 [ "tituloSerie" => "J Clin Anesth" "fecha" => "2007" "volumen" => "19" "paginaInicial" => "130" "paginaFinal" => "134" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17379126" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/08732159/0000001900000004/v2_201509041415/S0873215913000238/v2_201509041415/en/main.assets" "Apartado" => array:4 [ "identificador" => "9575" "tipo" => "SECCION" "pt" => array:2 [ "titulo" => "Artigos originais" "idiomaDefecto" => true ] "idiomaDefecto" => "pt" ] "PDF" => "https://static.elsevier.es/multimedia/08732159/0000001900000004/v2_201509041415/S0873215913000238/v2_201509041415/en/main.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215913000238?idApp=UINPBA00004E"]

Statistics

Original article

Patients with a high risk for obstructive sleep apnea syndrome: Postoperative respiratory complications

Doentes com alto risco de Apneia Obstrutiva do Sono: complicações respiratórias pós-operatórias

H. Pereiraa, D. Xaráa, J. Mendonçaa, A. Santosa, F.J. Abelhaa,b,

Corresponding author

fernando.abelha@gmail.com
abelha@me.com

Corresponding author.

a Department of Anesthesiology, Centro Hospitalar de São João, Porto, Portugal

b Anesthesiology and Perioperative Care Unit, Surgical Department of Medical School of Porto, Portugal

Read

24833

Times
was read the article

15154

Total PDF

9679

Total HTML

Share statistics

 array:25 [
  "pii" => "S0873215913000238"
  "issn" => "08732159"
  "doi" => "10.1016/j.rppneu.2013.01.003"
  "estado" => "S300"
  "fechaPublicacion" => "2013-07-01"
  "aid" => "138"
  "copyright" => "Sociedade Portuguesa de Pneumologia"
  "copyrightAnyo" => "2012"
  "documento" => "article"
  "crossmark" => 0
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "fla"
  "cita" => "Rev Port Pneumol. 2013;19:144-51"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 20451
    "formatos" => array:3 [
      "EPUB" => 304
      "HTML" => 6578
      "PDF" => 13569
    ]
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S0873215913000160"
    "issn" => "08732159"
    "doi" => "10.1016/j.rppneu.2013.01.001"
    "estado" => "S300"
    "fechaPublicacion" => "2013-07-01"
    "aid" => "133"
    "copyright" => "Sociedade Portuguesa de Pneumologia"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Pneumol. 2013;19:152-6"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 7738
      "formatos" => array:3 [
        "EPUB" => 255
        "HTML" => 5918
        "PDF" => 1565
      ]
    ]
    "pt" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Artigo original</span>"
      "titulo" => "Sonol&#234;ncia diurna e aten&#231;&#227;o em motoristas de &#243;nibus urbanos de 2 capitais do Brasil"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => "pt"
      "tieneResumen" => array:2 [
        0 => "pt"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "152"
          "paginaFinal" => "156"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Daytime sleepiness and attention in city bus drivers of two capitals of Brazil"
        ]
      ]
      "contieneResumen" => array:2 [
        "pt" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "pt" => true
      ]
      "contienePdf" => array:1 [
        "pt" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "D&#46; Brasil Santos, L&#46; Gon&#231;alves Bittencourt, C&#46;A&#46; de Assis Viegas, E&#46; Gaio"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "D&#46;"
              "apellidos" => "Brasil Santos"
            ]
            1 => array:2 [
              "nombre" => "L&#46;"
              "apellidos" => "Gon&#231;alves Bittencourt"
            ]
            2 => array:2 [
              "nombre" => "C&#46;A&#46;"
              "apellidos" => "de Assis Viegas"
            ]
            3 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "Gaio"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2173511513000456"
        "doi" => "10.1016/j.rppnen.2013.06.003"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511513000456?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215913000160?idApp=UINPBA00004E"
    "url" => "/08732159/0000001900000004/v2_201509041415/S0873215913000160/v2_201509041415/pt/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S0873215913000755"
    "issn" => "08732159"
    "doi" => "10.1016/j.rppneu.2013.06.002"
    "estado" => "S300"
    "fechaPublicacion" => "2013-07-01"
    "aid" => "162"
    "copyright" => "Sociedade Portuguesa de Pneumologia"
    "documento" => "simple-article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "edi"
    "cita" => "Rev Port Pneumol. 2013;19:142-3"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 5424
      "formatos" => array:3 [
        "EPUB" => 260
        "HTML" => 3945
        "PDF" => 1219
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
      "titulo" => "Obstructive Sleep Apnea and Surgery&#58; Wake up for the problem&#33;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "142"
          "paginaFinal" => "143"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Apneia Obstrutiva do Sono e Cirurgia&#58; prestem aten&#231;&#227;o"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Geraldo Lorenzi-Filho, Pedro Rodrigues Genta, Luciano Drager"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "Geraldo"
              "apellidos" => "Lorenzi-Filho"
            ]
            1 => array:2 [
              "nombre" => "Pedro Rodrigues"
              "apellidos" => "Genta"
            ]
            2 => array:2 [
              "nombre" => "Luciano"
              "apellidos" => "Drager"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215913000755?idApp=UINPBA00004E"
    "url" => "/08732159/0000001900000004/v2_201509041415/S0873215913000755/v2_201509041415/en/main.assets"
  ]
  "asociados" => array:2 [
    0 => array:19 [
      "pii" => "S0873215913000755"
      "issn" => "08732159"
      "doi" => "10.1016/j.rppneu.2013.06.002"
      "estado" => "S300"
      "fechaPublicacion" => "2013-07-01"
      "aid" => "162"
      "copyright" => "Sociedade Portuguesa de Pneumologia"
      "documento" => "simple-article"
      "crossmark" => 0
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "edi"
      "cita" => "Rev Port Pneumol. 2013;19:142-3"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 5424
        "formatos" => array:3 [
          "EPUB" => 260
          "HTML" => 3945
          "PDF" => 1219
        ]
      ]
      "en" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
        "titulo" => "Obstructive Sleep Apnea and Surgery&#58; Wake up for the problem&#33;"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "142"
            "paginaFinal" => "143"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "pt" => array:1 [
            "titulo" => "Apneia Obstrutiva do Sono e Cirurgia&#58; prestem aten&#231;&#227;o"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Geraldo Lorenzi-Filho, Pedro Rodrigues Genta, Luciano Drager"
            "autores" => array:3 [
              0 => array:2 [
                "nombre" => "Geraldo"
                "apellidos" => "Lorenzi-Filho"
              ]
              1 => array:2 [
                "nombre" => "Pedro Rodrigues"
                "apellidos" => "Genta"
              ]
              2 => array:2 [
                "nombre" => "Luciano"
                "apellidos" => "Drager"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215913000755?idApp=UINPBA00004E"
      "url" => "/08732159/0000001900000004/v2_201509041415/S0873215913000755/v2_201509041415/en/main.assets"
    ]
    1 => array:20 [
      "pii" => "S0873215913001360"
      "issn" => "08732159"
      "doi" => "10.1016/j.rppneu.2013.08.003"
      "estado" => "S300"
      "fechaPublicacion" => "2014-01-01"
      "aid" => "188"
      "copyright" => "Sociedade Portuguesa de Pneumologia"
      "documento" => "simple-article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "cor"
      "cita" => "Rev Port Pneumol. 2014;20:50-1"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 4387
        "formatos" => array:3 [
          "EPUB" => 244
          "HTML" => 3089
          "PDF" => 1054
        ]
      ]
      "en" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
        "titulo" => "Obstructive sleep apnea prevalence and adverse respiratory events in surgical patients"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "50"
            "paginaFinal" => "51"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "pt" => array:1 [
            "titulo" => "Preval&#234;ncia de apneia obstrutiva do sono e eventos respirat&#243;rios adversos em pacientes submetidos a cirurgia"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "autores" => array:2 [
          0 => array:2 [
            "autoresLista" => "R&#46; Reis"
            "autores" => array:1 [
              0 => array:2 [
                "nombre" => "R&#46;"
                "apellidos" => "Reis"
              ]
            ]
          ]
          1 => array:2 [
            "autoresLista" => "A&#46; Antunes"
            "autores" => array:1 [
              0 => array:2 [
                "nombre" => "A&#46;"
                "apellidos" => "Antunes"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2173511514000141"
          "doi" => "10.1016/j.rppnen.2013.08.001"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511514000141?idApp=UINPBA00004E"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215913001360?idApp=UINPBA00004E"
      "url" => "/08732159/0000002000000001/v2_201509041402/S0873215913001360/v2_201509041402/en/main.assets"
    ]
  ]
  "en" => array:19 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
    "titulo" => "Patients with a high risk for obstructive sleep apnea syndrome&#58; Postoperative respiratory complications"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "144"
        "paginaFinal" => "151"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "H&#46; Pereira, D&#46; Xar&#225;, J&#46; Mendon&#231;a, A&#46; Santos, F&#46;J&#46; Abelha"
        "autores" => array:5 [
          0 => array:3 [
            "nombre" => "H&#46;"
            "apellidos" => "Pereira"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "D&#46;"
            "apellidos" => "Xar&#225;"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "Mendon&#231;a"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "A&#46;"
            "apellidos" => "Santos"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          4 => array:4 [
            "nombre" => "F&#46;J&#46;"
            "apellidos" => "Abelha"
            "email" => array:2 [
              0 => "fernando&#46;abelha&#64;gmail&#46;com"
              1 => "abelha&#64;me&#46;com"
            ]
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Department of Anesthesiology&#44; Centro Hospitalar de S&#227;o Jo&#227;o&#44; Porto&#44; Portugal"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Anesthesiology and Perioperative Care Unit&#44; Surgical Department of Medical School of Porto&#44; Portugal"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "Doentes com alto risco de Apneia Obstrutiva do Sono&#58; complica&#231;&#245;es respirat&#243;rias p&#243;s-operat&#243;rias"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Obstructive sleep apnea &#40;OSA&#41; is a common medical condition affecting 2&#8211;26&#37; of the general population and it is the most prevalent breathing disturbance in sleep&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> OSA is characterized by repeated complete or partial collapse of the pharyngeal airway during sleep&#44; causing cessation of airflow &#40;apnoea&#41; or shallow breathing &#40;hypopnea&#41;&#46; This pattern of sleep arousal&#44; coupled with intermittent hypoxemia&#44; is associated with serious adverse cardiovascular outcomes&#44; including strokes&#44; and leads to daytime somnolence and compromised neurocognitive function&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The prevalence of OSA in the surgical population is higher than in the general population and it can vary widely according to the underlying medical condition&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> In particular&#44; as many as 70&#37; of patients undergoing bariatric surgery were found to have OSA&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> OSA has been recognized as a potential independent risk factor for adverse perioperative outcome&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Compared to non-OSA patients&#44; OSA patients undergoing surgical procedures are vulnerable to postoperative airway obstruction&#44;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> myocardial ischemia congestive heart failure&#44; stroke and oxygen desaturation&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;7&#44;8</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The gold standard for the diagnosis of OSA&#44; polysomnography &#40;PSG&#41;&#44; is impracticable as a routine preoperative assessment tool for OSA because it is an expensive and labor intensive test&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Many tools have been proposed for screening patients for OSA such as the Berlin questionnaire&#44; the STOP questionnaire and the American Society of Anaesthesiologists &#40;ASA&#41; checklist &#8211; and the use of these tools improves the likelihood of identifying OSA preoperatively&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> The STOP questionnaire&#44; showed a high sensitivity for detecting OSA &#40;when score is &#8805;3&#41;&#58; 93&#37; and 100&#37; for moderate and severe OSA&#44; respectively&#59; however&#44; the specificity at the same cut-off is low&#58; 47&#37; and 37&#37; for moderate and severe OSA&#44; respectively&#44; resulting in high false-positive rates&#46; The STOP questionnaire is a scoring model consisting of 8 easily administrated questions starting with the acronym STOP-BANG &#40;<a class="elsevierStyleCrossRef" href="#sec0065">Appendix</a>&#41; and is scored based on Yes&#47;No answers &#40;scores 1&#47;0&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The aim of this study was to evaluate the incidence of patients with a STOP-BANG score<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>3&#44; in surgical patients admitted in the Post-Anesthesia Care Unit &#40;PACU&#41;&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Subjects and settings</span><p id="par0025" class="elsevierStylePara elsevierViewall">Ethical approval for this study was provided by the Ethics Committee of Centro Hospitalar S&#227;o Jo&#227;o&#44; Porto&#44; Portugal&#46; Written informed consent was obtained from all participants&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Centro Hospitalar S&#227;o Jo&#227;o&#44; Porto&#44; is an 1124-bed tertiary hospital in a major metropolitan area that serves 3&#44;000&#44;000 people&#46; This prospective study was conducted in a 12-bed PACU over a 3-week period &#40;from May 9th to May 27th&#44; 2011&#41;&#46; Every patient admitted to the PACU who was able to provide written informed consent was included in the study&#46; Exclusion criteria were patient refusal&#44; incapacity to provide informed consent&#44; a score of &#60;25 in the mini-mental state examination &#40;MMSE&#41;&#44; under 18 years of age&#44; foreign nationality&#44; known neuromuscular disease&#44; urgent&#47;emergent surgery and cardiac surgery&#44; neurosurgery or other procedures that required therapeutic hypothermia&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">All the patients were asked to complete the STOP questionnaire&#46; Information concerning body mass index &#40;BMI&#41; age&#44; neck circumference&#44; and gender &#40;Bang&#41; were collected by a research assistant&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Patients were classified as being at high risk for obstructive sleep apnea &#40;HR-OSA&#41; if their STOP-BANG score was 3 or greater and as being at low risk of OSA &#40;LR-OSA&#41; if their score was less than 3&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The anesthesiologist in charge was blinded to patient involvement in the study&#46; Anesthesia was provided and monitored according to the anesthesiologist in charge criteria&#44; but this conduct followed minimum departmental standards&#46; Neuromuscular blocking drugs &#40;NMBD&#41; were used for tracheal intubation&#44; and additional boluses were provided&#44; if needed&#46; No written policy exists concerning the use of neuromuscular monitoring so this was performed at the discretion of the anesthesiologist&#46; To ensure that the anesthesiologist remained blinded to the patients&#8217; participation in the study&#44; we did not attempt to observe the use or interpretation of TOF intraoperatively&#46; The anesthesiologist was free to decide whether to reverse the neuromuscular blockade &#40;NMB&#41; with neostigmine at the conclusion of the surgical procedure&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Usually&#44; the patient was extubated in the operating room and transferred to the PACU&#46; Criteria for extubation included sustained head lift or hand grip for more than 5<span class="elsevierStyleHsp" style=""></span>s&#44; the ability to follow simple commands&#44; a stable ventilatory pattern with acceptable arterial oxygen saturation &#40;SpO<span class="elsevierStyleInf">2</span>&#41;<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>95&#37;&#44; and a TOF ratio greater than 0&#46;80&#46; All subjects were administered 100&#37; oxygen by a facemask after tracheal extubation&#46; The anesthesiologist was free to decide whether to administer oxygen during the time between transfer to the cart and admission to the PACU&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Upon arrival at the PACU all subjects were provided with oxygen either by a nasal cannula or face mask&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">A standardized data collection sheet was completed for each patient&#46; The recorded patient characteristics were&#58; age&#44; weight&#44; height&#44; body mass index &#40;BMI&#41;&#44; benzodiazepine administration before surgery&#44; chronic benzodiazepine use&#44; site of surgery &#40;intra-abdominal&#44; musculoskeletal or head and neck&#41;&#44; American Society of Anesthesiologists physical status &#40;ASA-PS&#41;&#44; Revised Cardiac Risk Index &#40;RCRI&#41;&#44; drug or alcohol abuse&#44; duration of preoperative fluid fasting&#44; type of anesthesia&#44; duration of surgery&#44; use of nitrous oxide&#44; adverse respiratory events in the PACU&#44; postoperative pain level &#40;VAS score&#41;&#44; postoperative nausea and vomiting 6<span class="elsevierStyleHsp" style=""></span>hours after surgery and 24<span class="elsevierStyleHsp" style=""></span>h after surgery&#44; length of stay in the PACU&#44; and postoperative length of stay in hospital&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">The surgical procedure was classified in terms of magnitude&#44; as major &#40;surgery in which body cavities or major vessels are exposed to ambient temperature such as major abdominal&#44; thoracic&#44; or major vascular&#44; thoracic spine surgery with instrumentation&#44; or hip arthroplasty&#41;&#44; medium &#40;surgery in which body cavities are exposed to a lesser degree such as appendectomy&#41;&#44; and minor surgery &#40;superficial surgery&#41;&#46; Major surgery was defined as a surgery requiring a hospital stay of 2 or more days&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Clinical risk factors &#40;a history of ischemic heart disease&#44; history of compensated or prior heart failure&#44; history of cerebrovascular disease&#44; diabetes mellitus&#44; and renal insufficiency&#41; and surgical risk &#40;high-risk defined as intrathoracic&#44; intraperitoneal&#44; or suprainguinal vascular surgery&#44; or surgery involving large blood loss or fluid shifts&#41; were defined according to the Cardiac Risk Stratification for Noncardiac Surgical Procedures of the 2007 guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery of the American College of Cardiology&#47;American Heart Association Task Force on Practice Guidelines&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Data for other preoperative clinical information regarding chronic obstructive pulmonary disease &#40;COPD&#41;&#44; hypertension and dyslipidemia were collected from routine clinical documentation entered into the institution&#39;s perioperative clinical information system&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Residual neuromuscular blocking was defined as a TOF<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;9 and it was quantified at admission to the PACU using acceleromyography of the adductor pollicis muscle &#40;TOF-Watch<span class="elsevierStyleSup">&#174;</span>&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#44;11</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">The patients were screened for delirium at PACU discharge and in the ward the next day after surgery using the nursing delirium screening scale &#40;Nu-DESC&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> Patients with a Nu-DESC score of 2 or more points during at least at 1 evaluation were considered delirium positive&#46; Patients were tested for delirium by the research team at the time they were formally declared to be &#8216;ready for discharge&#8217; to the regular ward by the physician in charge of the recovery room&#46; In addition&#44; the patients were seen on the morning of the first postoperative day&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Postoperative respiratory complications</span><p id="par0090" class="elsevierStylePara elsevierViewall">Each postoperative ARE was defined on the data collection sheet using the following criteria according to the classification described by Murphy et al<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a>&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1&#46;</span><p id="par0095" class="elsevierStylePara elsevierViewall">Upper airway obstruction requiring an intervention &#40;jaw thrust&#44; or oral or nasal airway&#41;&#59;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2&#46;</span><p id="par0100" class="elsevierStylePara elsevierViewall">Mild-moderate hypoxia &#40;SpO<span class="elsevierStyleInf">2</span> of 93&#8211;90&#37;&#41; on 3<span class="elsevierStyleHsp" style=""></span>L nasal cannula O<span class="elsevierStyleInf">2</span> that was not improved after active interventions &#40;increasing O<span class="elsevierStyleInf">2</span> flows to &#62;3<span class="elsevierStyleHsp" style=""></span>L&#47;min&#44; application of high-flow face mask O<span class="elsevierStyleInf">2</span>&#44; verbal requests to breathe deeply and tactile stimulation&#41;&#59;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">3&#46;</span><p id="par0105" class="elsevierStylePara elsevierViewall">Severe hypoxia &#40;SpO<span class="elsevierStyleInf">2</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>90&#37;&#41; on 3<span class="elsevierStyleHsp" style=""></span>L nasal cannula O<span class="elsevierStyleInf">2</span> that was not improved after active interventions &#40;increasing O<span class="elsevierStyleInf">2</span> flows to &#62;3<span class="elsevierStyleHsp" style=""></span>L&#47;min&#44; application of high-flow facemask O<span class="elsevierStyleInf">2</span>&#44; verbal requests to breathe deeply&#44; and tactile stimulation&#41;&#59;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">4&#46;</span><p id="par0110" class="elsevierStylePara elsevierViewall">Signs of respiratory distress or impending ventilatory failure &#40;respiratory rate &#62;20 breaths per minute&#44; accessory muscle use&#44; and tracheal tug&#41;&#59;</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">5&#46;</span><p id="par0115" class="elsevierStylePara elsevierViewall">Inability to breathe deeply when requested to by the PACU nurse&#59;</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">6&#46;</span><p id="par0120" class="elsevierStylePara elsevierViewall">Patient complaining of symptoms of respiratory or upper airway muscle weakness &#40;difficulty breathing&#44; swallowing&#44; or speaking&#41;&#59;</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">7&#46;</span><p id="par0125" class="elsevierStylePara elsevierViewall">Patient requiring reintubation in the PACU&#59;</p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">8&#46;</span><p id="par0130" class="elsevierStylePara elsevierViewall">Clinical evidence or suspicion of pulmonary aspiration after tracheal extubation &#40;gastric contents observed in the oropharynx and hypoxemia&#41;&#46;</p></li></ul></p><p id="par0135" class="elsevierStylePara elsevierViewall">The PACU nurses observed the patients continuously during the PACU stay and contacted a study investigator immediately if an ARE was observed&#46; The inability to breathe deeply and the assessment of symptoms of respiratory or upper airway muscle weakness were assessed at 10-minute intervals&#46; A study investigator examined the patient to confirm that the patient met at least one of the criteria for an ARE&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Statistical method</span><p id="par0140" class="elsevierStylePara elsevierViewall">Descriptive analysis of variables was used to summarize data&#46; Ordinal and continuous data found not to follow a normal distribution&#44; based on the Kolmogorov&#8211;Smirnov test for normality of the underlying population&#44; are presented as median and interquartile range&#46; Normally distributed data are presented as mean and standard deviation &#40;SD&#41;&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">A univariate analysis was performed to identify differences between HR-OSA and LR-OSA patients by using the Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span>-test to compare continuous variables and the Chi-square or Fisher&#39;s exact test to compare proportions between the 2 groups of subjects&#46; Differences were considered statistically significant when <span class="elsevierStyleItalic">P</span> was &#60;0&#46;05&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">A univariate analysis was performed to identify predictors for ARE&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Multiple regression binary logistic was used with forward conditional method in the model in order to identify independent predictors for ARE&#46; In this model&#44; all covariates with <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05 in the univariate analyses were entered and an odds ratio &#40;OR&#41; and 95&#37; Confidence Interval <span class="elsevierStyleItalic">&#40;95&#37; CI&#41;</span> were calculated&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Data were analyzed using SPSS software for Windows Version 19&#46;0 &#40;SPSS Inc&#46;&#44; Chicago&#44; IL&#44; USA&#41;&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Results</span><p id="par0165" class="elsevierStylePara elsevierViewall">From the 357 patients consecutively admitted to the PACU during the study period&#44; a total of 340 patients were studied&#46; Seventeen patients were excluded&#58; 7 patients were admitted to a surgical intensive care unit&#44; 3 patients were unable to provide informed consent or had a MMSE &#60;25&#44; 3 patients did not undergo surgery&#44; 1 patient underwent neurosurgery&#44; 1 patient was less than 18 years old&#44; 1 patient did not speak Portuguese and 1 patient refused to participate&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Of the 340 patients included in the analysis &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#44; 179 &#40;52&#37;&#41; were classified as HR-OSA&#46; These patients were older &#40;mean age of 61&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#46;4 vs&#46; 48&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&#46;0 years and median age 63 vs&#46; 47 years&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; were more likely to be men &#40;63&#37; vs&#46; 21&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; had higher BMI &#40;mean 29&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#46;0 vs&#46; 25&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;4<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#44; median 28 vs&#46; 24<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; higher ASA physical status &#40;ASA III&#44; IV or V 26&#37; vs&#46; 10&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and higher RCRI scores &#40;RCRI<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>2 in 7&#37; vs&#46; 2&#37;&#41;&#46; Patients with HR-OSA had a higher incidence of ischemic heart disease &#40;10&#37; vs&#46; 2&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; heart failure &#40;8&#37; vs&#46; 3&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;032&#41;&#44; hypertension &#40;62&#37; vs&#46; 19&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; dyslipidemia &#40;41&#37; vs&#46; 12&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and underwent more frequently insulin treatment for diabetes &#40;24&#37; vs&#46; 4&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; The prevalence of cerebrovascular disease &#40;4&#37; vs&#46; 1&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;116&#41; and preoperative serum creatinine &#62;2<span class="elsevierStyleHsp" style=""></span>mg&#47;dl &#40;6&#37; vs&#46; 4&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;394&#41; were not significantly different between the 2 groups&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0175" class="elsevierStylePara elsevierViewall">HR-OSA patients were more likely to undergo intra-abdominal surgery &#40;43&#37; vs&#46; 29&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;011&#41; and surgery of major magnitude &#40;32&#37; vs&#46; 22&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;033&#41;&#44; had more frequently loco regional anesthesia as a unique technique &#40;26&#37; vs&#46; 14&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;009&#41; and less frequently had general or combined general and loco regional anesthesia &#40;74&#37; vs&#46; 86&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;009&#41;&#46; Patients classified as HR-OSA had a higher incidence of residual NMB &#40;RNMB&#41; &#40;20&#37; vs&#46; 16&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;035&#41;&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">In relation to respiratory events &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41; that occurred in the PACU&#44; HR-OSA patients had more frequently experienced mild&#47;moderated hypoxia &#40;9&#37; vs&#46; 3&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;012&#41;&#46; The length of the hospital stay &#40;median 5 days vs&#46; 3 days&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#44; but not the length of the PACU stay &#40;96 vs&#46; 91<span class="elsevierStyleHsp" style=""></span>minutes&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;064&#41;&#44; was higher in these patients&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0185" class="elsevierStylePara elsevierViewall">In multivariate analyses for ARE occurrence &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41; and after adjustment for univariate predictors &#40;gender&#44; intra-abdominal surgery&#44; major surgery&#44; cardiovascular high-risk surgery&#44; general anesthesia and&#47;or combined anesthesia&#44; use of neuromuscular relaxants and postoperative residual neuromuscular blockade&#41; the occurrence of residual neuromuscular blockade was identified as an independent predictor of ARE&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0190" class="elsevierStylePara elsevierViewall">In these analyses HR-OSA was not a determinant for ARE &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;142&#41; and was not entered in the multivariate model&#46; HR-OSA is shown in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> but it was not introduced in the model because it was not considered determinant for ARE&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Discussion</span><p id="par0195" class="elsevierStylePara elsevierViewall">The incidence of patients with HR-OSA was 52&#37; in our study&#44; which indicates that this is an important matter for concern among patients scheduled for surgery in our hospital&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">We relied on a STOP-BANG score<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>3 for this study&#44; since this was demonstrated to be a highly sensitive test for moderate&#47;severe OSA&#46; Indeed&#44; Chung et al&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> suggested that this cut-off is appropriate for the surgical population<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> and further stated that the STOP-BANG questionnaire is concise&#44; easy to use&#44; and its importance lies in the identification of patients at high risk of OSA which may help to prevent postoperative complications&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">The HR-OSA group of patients had a significantly higher percentage of men and as expected the BMI was significantly different between the LR-OSA and HR-OSA groups &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; Similar results have been reported previously&#46;<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">15&#44;16</span></a> The importance of these findings is revealed by the presence of these variables in different tools such as the sleep apnea clinical score &#40;SACS&#41; and even the STOP-BANG&#44; used to assess OSA severity&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">The association between increased morbidity and untreated OSA is well established&#44; which may result in an increased mortality rate&#46;<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">17&#44;18</span></a> Furthermore&#44; these patients are at a greater risk of developing cardiovascular disease&#46; Indeed&#44; HR-OSA patients had more frequently cardiac comorbidities &#40;ischemic heart disease and congestive heart failure&#41;&#44; hypertension&#44; dyslipidaemia and pulmonary chronic disease in our study&#46; These comorbidities may&#44; however&#44; have reflected higher ASA and RCRI scores&#44; which would indirectly indicate the presence of more important associated comorbidities in patients at a higher risk of having OSA&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">Our results show that HR-OSA patients more frequently underwent bariatric surgery&#44; abdominal surgery&#44; and major surgery&#46; Thus&#44; it is possible that the risks associated with major surgery and bariatric surgery may account for the higher complication rates rather than the diagnosis of HR-OSA in itself&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">We found that the length of the hospital stay was higher in HR-OSA patients&#44; which is in agreement with the study of Liu et al&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> This suggests postoperative hypoxemia is associated with adverse outcomes including the need for more frequent respiratory interventions and more intensive monitoring which may led to a longer hospital stay</p><p id="par0225" class="elsevierStylePara elsevierViewall">The incidence of RNMB was higher in HR-OSA patients&#46; In addition&#44; a higher incidence of RNMB was found in patients with a high BMI&#44;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20&#44;21</span></a> which may be due to the accumulation of neuromuscular blocker in the adipose tissue&#46; These data suggest that enhanced monitoring is important when HR-OSA patients are exposed to additional risk factors for respiratory complications like RNMB&#44; or when these patients are given drugs that enhance neuromuscular blockade&#46;</p><p id="par0230" class="elsevierStylePara elsevierViewall">Perioperative complications&#44; including respiratory events&#44; were more frequent in patients with HR-OSA&#46; Compared with patients without this diagnosis&#44; we found that the HR-OSA patients more frequently experienced mild&#47;moderated hypoxia in the PACU and there was a greater risk of postoperative hypoxemia in HR-OSA patients in comparison with those without the diagnosis&#46; This is consistent with the results of the study of Gali et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> which found that respiratory events were more frequent in patients with a high risk of OSA&#46; However&#44; in our study&#44; as in the study of Chung et al&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> analysis of perioperative adverse events did not show significant respiratory morbidity in HR-OSA patients compared to the LR-OSA patients&#46; In fact in our study we did not find that HR-OSA was a determinant for ARE&#46;</p><p id="par0235" class="elsevierStylePara elsevierViewall">This study has several limitations&#46; The first and most important limitation is that it was not possible to compare the results of the STOP-BANG questionnaire with a definitive polysomnographic diagnosis&#46;</p><p id="par0240" class="elsevierStylePara elsevierViewall">Second&#44; our patients may have been at high risk for postoperative events without having OSA&#46; The use of the STOP-BANG score is as an instrument to predict the risk of a patient to having OSA may have led to a high incidence of false positive results&#46; It is possible that a higher score should have been used because recent studies have shown that the STOP-BANG score has a higher accuracy in detecting moderate to severe OSA patients in a surgical population when the score is greater than or equal to 5&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0245" class="elsevierStylePara elsevierViewall">Third&#44; the respiratory events were only registered in the PACU and complications that could have occurred after PACU discharge were not considered&#46; This might be viewed as a major limitation since respiratory complications after surgery may be associated with adverse outcomes that occur during the hospital stay after PACU discharge&#46;</p><p id="par0250" class="elsevierStylePara elsevierViewall">Fourth&#44; the fact that HR-OSA patients more frequently underwent major surgery may be viewed as a confounding factor and a limitation of the study because it indicates that the patient groups were non-homogeneous&#46;</p><p id="par0255" class="elsevierStylePara elsevierViewall">In conclusion&#44; the principal findings of this study are as follows&#58;<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">-</span><p id="par0260" class="elsevierStylePara elsevierViewall">HR-OSA patients have a higher incidence of postoperative respiratory complications&#59;</p></li><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">-</span><p id="par0265" class="elsevierStylePara elsevierViewall">mild&#47;moderate hypoxia was the most frequent pulmonary adverse event in the immediate postoperative period that occurred more frequently in HR-OSA patients&#59;</p></li><li class="elsevierStyleListItem" id="lsti0055"><span class="elsevierStyleLabel">-</span><p id="par0270" class="elsevierStylePara elsevierViewall">HR-OSA patients had more comorbidities including ischemic heart disease&#44; congestive heart failure&#44; diabetes treated with insulin&#44; chronic pulmonary disease&#44; hypertension and dyslipidemia&#59;</p></li><li class="elsevierStyleListItem" id="lsti0060"><span class="elsevierStyleLabel">-</span><p id="par0275" class="elsevierStylePara elsevierViewall">HR-OSA patients required a longer stay in the hospital&#46;</p></li><li class="elsevierStyleListItem" id="lsti0065"><span class="elsevierStyleLabel">-</span><p id="par0280" class="elsevierStylePara elsevierViewall">HR-OSA was not a determinant for ARE&#46;</p></li></ul></p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Ethical disclosures</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Protection of human and animal subjects</span><p id="par0285" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Confidentiality of data</span><p id="par0290" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data and that all the patients included in the study received sufficient information and gave their written informed consent to participate in the study&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Right to privacy and informed consent</span><p id="par0295" class="elsevierStylePara elsevierViewall">The authors have obtained the written informed consent of the patients or subjects mentioned in the article&#46; The corresponding author is in possession of this document&#46;</p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflicts of interest</span><p id="par0300" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:11 [
        0 => array:3 [
          "identificador" => "xres547728"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Background"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Methods"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec565608"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres547729"
          "titulo" => "Resumo"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Introdu&#231;&#227;o"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "M&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclus&#245;es"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec565609"
          "titulo" => "Palavras-chave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Methods"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Subjects and settings"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Postoperative respiratory complications"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Statistical method"
            ]
          ]
        ]
        6 => array:2 [
          "identificador" => "sec0030"
          "titulo" => "Results"
        ]
        7 => array:2 [
          "identificador" => "sec0035"
          "titulo" => "Discussion"
        ]
        8 => array:3 [
          "identificador" => "sec0040"
          "titulo" => "Ethical disclosures"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Protection of human and animal subjects"
            ]
            1 => array:2 [
              "identificador" => "sec0050"
              "titulo" => "Confidentiality of data"
            ]
            2 => array:2 [
              "identificador" => "sec0055"
              "titulo" => "Right to privacy and informed consent"
            ]
          ]
        ]
        9 => array:2 [
          "identificador" => "sec0060"
          "titulo" => "Conflicts of interest"
        ]
        10 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2012-10-03"
    "fechaAceptado" => "2013-01-30"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec565608"
          "palabras" => array:4 [
            0 => "Obstructive sleep apnea"
            1 => "STOP-BANG score"
            2 => "Surgery"
            3 => "Postoperative complications"
          ]
        ]
      ]
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras-chave"
          "identificador" => "xpalclavsec565609"
          "palabras" => array:4 [
            0 => "Apneia obstrutiva do sono"
            1 => "Pontua&#231;&#227;o STOP-BANG"
            2 => "Cirurgia"
            3 => "Complica&#231;&#245;es p&#243;s-operat&#243;rias"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">STOP-BANG score &#40;snore&#59; tired&#59; observed apnea&#59; arterial pressure&#59; body mass index&#59; age&#59; neck circumference and gender&#41; can predict the risk of a patient having Obstructive Syndrome Apnea &#40;OSA&#41;&#46; The aim of this study was to evaluate the incidence STOP-BANG score<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>3&#44; in surgical patients admitted to the Post-Anesthesia Care Unit &#40;PACU&#41;&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Observational&#44; prospective study conducted in a post-anesthesia care unit &#40;PACU&#41; during three weeks &#40;2011&#41;&#46; The study population consisted of adult patients after noncardiac and non-neurological surgery&#46; Patients were classified as high risk of OSA &#40;HR-OSA&#41; if STOP-BANG score<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>3 and Low-risk of OSA &#40;LR-OSA&#41; if STOP-BANG score<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>3 &#40;LR-OSA&#41;&#46; Patient demographics&#44; intraoperative and postoperative data were collected&#46; Patient characteristics were compared using Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span>-test&#44; <span class="elsevierStyleItalic">t</span>-test for independent groups&#44; and chi-square or Fisher&#39;s exact test&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A total of 357 patients were admitted to PACU&#59; 340 met the inclusion criteria&#46; 179 &#40;52&#37;&#41; were considered HR-OSA&#46; These patients were older&#44; more likely to be masculine&#44; had higher BMI&#44; higher ASA physical status&#44; higher incidence of ischemic heart disease&#44; heart failure&#44; hypertension&#44; dyslipidemia and underwent more frequently insulin treatment for diabetes&#46; These patients had more frequently mild&#47;moderated hypoxia in the PACU &#40;9&#37; vs&#46; 3&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;012&#41; and had a higher incidence of residual neuromuscular blockade &#40;NMB&#41; &#40;20&#37; vs&#46; 16&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;035&#41;&#46; Patients with HR-OSA had a longer hospital stay&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Patients with HR-OSA had an important incidence among patients scheduled for surgery in our hospital&#46; These patients had more co-morbidities and were more prone to post-operative complications&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Background"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "pt" => array:3 [
        "titulo" => "Resumo"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introdu&#231;&#227;o</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A pontua&#231;&#227;o no STOP-BANG &#40;Snore&#44; Tired&#44; Observed apnea&#44; blood Pressure&#41; pode prever o risco de um doente ter S&#237;ndrome da Apneia Obstrutiva Sono &#40;SAOS&#41;&#46; O objetivo deste estudo foi avaliar a incid&#234;ncia da pontua&#231;&#227;o STOP BANG&#62; 3&#44; em pacientes cir&#250;rgicos internados na Unidade de Cuidados P&#243;s-Anest&#233;sica &#40;UCPA&#41;&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudo observacional e prospectivo conduzido numa UCPA&#44; durante tr&#234;s semanas &#40;2011&#41;&#46; A popula&#231;&#227;o de estudo consistiu em doentes adultos ap&#243;s cirurgia n&#227;o card&#237;aca e n&#227;o neurol&#243;gica&#46; Os doentes foram considerados com alto risco de SAOS &#40;AR-SAOS&#41; se tinham um score de STOP-BANG &#8805;3 e de baixo risco de SAOS &#40;BR-SAOS&#41; se tinham score de STOP-BANG &#60;3&#46; Foram avaliados dados demogr&#225;ficos dos doentes e colhidas vari&#225;veis intraoperat&#243;rias e p&#243;s-operat&#243;rias&#46; As caracter&#237;sticas dos doentes foram comparadas atrav&#233;s do teste de Mann-Whitney&#44; teste t&#44; qui-quadrado ou teste exato de Fisher&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Um total de 357 doentes foram admitidos de UCPA e 340 preencheram os crit&#233;rios de inclus&#227;o&#46; Cento e setenta e nove &#40;52&#37;&#41; tinham AR-SAOS&#46; Estes doentes eram mais velhos&#44; tinham maior probabilidade de serem do sexo masculino&#44; tinham um &#205;ndice Massa Corporal superior&#44; tiveram uma classifica&#231;&#227;o maior no estado f&#237;sico American Society Anesthesiologists&#44; uma maior incid&#234;ncia de doen&#231;a card&#237;aca isqu&#233;mica&#44; insufici&#234;ncia card&#237;aca&#44; hipertens&#227;o&#44; dislipidemia e eram mais frequentemente doentes com diabetes em tratamento com insulina&#46; Esses doentes tiveram mais frequentemente hip&#243;xia leve&#47;moderado na UCPA &#40;9&#37; versus 3&#37;&#44; P<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;012&#41; e tiveram maior incid&#234;ncia de bloqueio neuromuscular residual &#40;NMB&#41; &#40;20&#37; versus 16&#37;&#44; P<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;035&#41;&#46; Os doentes com AR-SAOS tiveram maior tempo de internamento hospitalar&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#245;es</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Os doentes com AR-SAOS tem uma alta incid&#234;ncia entre os doentes submetidos a interven&#231;&#245;es cir&#250;rgicas programadas no nosso hospital&#46; Esses doentes tinham mais comorbilidades e foram mais propensos a ter complica&#231;&#245;es p&#243;s-operat&#243;rias&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introdu&#231;&#227;o"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "M&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclus&#245;es"
          ]
        ]
      ]
    ]
    "apendice" => array:1 [
      0 => array:1 [
        "seccion" => array:1 [
          0 => array:4 [
            "apendice" => "<p id="par0305" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="fig0005"></elsevierMultimedia></p>"
            "etiqueta" => "Appendix A"
            "titulo" => "STOP-Bang Scoring Model"
            "identificador" => "sec0065"
          ]
        ]
      ]
    ]
    "multimedia" => array:4 [
      0 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">HR-OSA &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>179&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">LR-OSA <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>161&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Age&#44; median &#40;IQR&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63 &#40;55&#8211;71&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">47 &#40;36&#8211;61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Gender&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">113 &#40;63&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33 &#40;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66 &#40;37&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">128 &#40;80&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Site of Surgery&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Intraabdominal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">76 &#40;43&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">47 &#40;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;011<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Musculoskeletal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">88 &#40;49&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">91 &#40;57&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;175<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Head and Neck&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;084<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Body mass index &#40;kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#41;&#44; median &#40;IQR&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;25&#8211;32&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24 &#40;22&#8211;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">ASA physical status&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>I&#47;II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">132 &#40;74&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">145 &#40;90&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>III&#47;IV&#47;V&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">47 &#40;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">High risk surgery&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57 &#40;32&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36 &#40;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;050<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Ischemic heart disease&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Congestive heart disease&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;032<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Cerebrovascular disease&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;116<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Insulin therapy for diabetes&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42 &#40;24&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Renal insufficiency&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;394<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">RCRI&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;030<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>RCRI<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">167&#40;93&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">158 &#40;98&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>RCRI<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Hypertension&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">111&#40;62&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Dyslipidemia&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">73&#40;41&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19 &#40;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">COPD&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;015<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Type of anesthesia&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;009<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Loco regional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">46 &#40;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>General&#47;combined&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">133 &#40;74&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">138 &#40;86&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Magnitude of surgery&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Minor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;114<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Medium&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">108 &#40;63&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">104 &#40;65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;481<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Major&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57 &#40;32&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36 &#40;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;033<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Bariatric surgery&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;016<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Duration surgery&#44; median &#40;IQR&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">87 &#40;50&#8211;135&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">75 &#40;50&#8211;120&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;173<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Post-operative delirium hospital&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;400<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Temperature on admission&#44; median &#40;IQR&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35&#46;3 &#40;34&#46;9&#8211;35&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35&#46;4 &#40;34&#46;9&#8211;35&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;158<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#60;35<span class="elsevierStyleHsp" style=""></span>&#176;C&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">104 &#40;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;424<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Length of PACU stay minutes&#44; median &#40;IQR&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">96 &#40;67&#8211;145&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">91 &#40;65&#8211;120&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;064<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Length of Hospital stay &#40;days&#41;&#44; median &#40;IQR&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;2&#8211;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;2&#8211;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;010<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Perioperative muscle relaxants use&#44; n&#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">99 &#40;55&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">106 &#40;66&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;048<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Neuromuscular residual blocking&#44; n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35&#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25 &#40;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;035<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab884679.png"
              ]
            ]
          ]
          "notaPie" => array:3 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Pearson&#39;s chi-squared test&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Fisher&#39;s exact test&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0015"
              "etiqueta" => "c"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span>-test IQR&#44; interquartile range HR-OSA&#44; high-risk of OSA&#59; ASA&#44; American Society of Anesthesiologists&#59; RCRI&#44; revised cardiac risk index&#59; COPD&#44; Chronic Pulmonary Obstructive Disease&#59; PACU&#44; Post Anesthesia Care Unit&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Patient baseline characteristics &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>340&#41;&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">All &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>340&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">HR-OSA <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>179&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">LR-OSA <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>161&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Respiratory events</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39 &#40;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25 &#40;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;140&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Obstruction airway&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;475&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hypoxia &#40;mild&#47;moderate&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19 &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;012&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hypoxia Severe&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;529&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Respiratory failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;253&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Inspiratory capacity decreased&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49&#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;407&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Muscle weakness&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;132&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab884681.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Respiratory complications &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>340&#41;&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Simple OR &#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">b</span></a>OR &#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span><a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Gender&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;9 &#40;1&#46;0&#8211;3&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;038&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Intra-abdominal surgery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;8 &#40;1&#46;0&#8211;3&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;049&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">General&#47;combined anesthesia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;9 &#40;1&#46;3&#8211; 6&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;013&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">NMBD use&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;8 &#40;1&#46;5&#8211;5&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">RNMB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;1 &#40;3&#46;1 &#8211;12&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;9 &#40;2&#46;8&#8211;12&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">High risk surgery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;3 &#40;1&#46;3&#8211;4&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Major surgery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;8 &#40;1&#46;0&#8211;3&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;045&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">HR-OSA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;5 &#40;0&#46;9&#8211;2&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;145&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab884680.png"
              ]
            ]
          ]
          "notaPie" => array:2 [
            0 => array:3 [
              "identificador" => "tblfn0020"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Logistic regression analysis with forward conditional elimination method was used with an entry criterion of <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46;</p> <p class="elsevierStyleNotepara" id="npar0025">OR&#59; odds ratio&#59; CI&#44; Confidence Interval&#59; NMBD&#44; neuromuscular blocking drugs&#59; RNMB&#44; residual neuromuscular blockade&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0025"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0030">Adjusted OR for gender&#44; intra-abdominal surgery&#44; high-risk surgery&#44; major surgery&#44; NMBD use and RNMB &#40;variables considered to be determinants for ARE in a univariate analyses&#41;&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Multivariate regression analysis for predictors of adverse respiratory events&#46;</p>"
        ]
      ]
      3 => array:5 [
        "identificador" => "fig0005"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx1.jpeg"
            "Alto" => 3660
            "Ancho" => 3334
            "Tamanyo" => 500994
          ]
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:22 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "High STOP-Bang score indicates a high probability of obstructive sleep apnoea"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "F&#46; Chung"
                            1 => "R&#46; Subramanyam"
                            2 => "P&#46; Liao"
                            3 => "E&#46; Sasaki"
                            4 => "C&#46; Shapiro"
                            5 => "Y&#46; Sun"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/bja/aes022"
                      "Revista" => array:7 [
                        "tituloSerie" => "Br J Anaesth"
                        "fecha" => "2012"
                        "volumen" => "108"
                        "paginaInicial" => "768"
                        "paginaFinal" => "775"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22401881"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0140673601061025"
                          "estado" => "S300"
                          "issn" => "01406736"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "STOP questionnaire&#8212;a tool to screen patients for obstructive sleep apnea"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "F&#46; Chung"
                            1 => "B&#46; Yegneswaran"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Anesthesiology"
                        "fecha" => "2008"
                        "volumen" => "V"
                        "paginaInicial" => "812"
                        "paginaFinal" => "821"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Perioperative management of obstructive sleep apnea&#58; ready for prime time&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46; Shafazand"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3949/ccjm.76.s4.16"
                      "Revista" => array:7 [
                        "tituloSerie" => "Cleve Clin J Med"
                        "fecha" => "2009"
                        "volumen" => "76"
                        "numero" => "Suppl&#46;"
                        "paginaInicial" => "S98"
                        "paginaFinal" => "S103"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19880843"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Interactions between obesity and obstructive sleep apnea&#58; implications for treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Romero-Corral"
                            1 => "S&#46;M&#46; Caples"
                            2 => "F&#46; Lopez-Jimenez"
                            3 => "V&#46;K&#46; Somers"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1378/chest.09-0360"
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2010"
                        "volumen" => "137"
                        "paginaInicial" => "711"
                        "paginaFinal" => "719"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20202954"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk assesment of obstructive sleep apnea in a population of patients undergoing ambulatory surgery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46; Tracey"
                            1 => "C&#46; Wright"
                            2 => "A&#46; George"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "J Clin Sleep Med"
                        "fecha" => "2010"
                        "volumen" => "6"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk assessment of obstructive sleep apnea in a population of patients undergoing ambulatory surgery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "T&#46;L&#46; Stierer"
                            1 => "C&#46; Wright"
                            2 => "A&#46; George"
                            3 => "R&#46;E&#46; Thompson"
                            4 => "C&#46;L&#46; Wu"
                            5 => "N&#46; Collop"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Sleep Med"
                        "fecha" => "2010"
                        "volumen" => "6"
                        "paginaInicial" => "467"
                        "paginaFinal" => "472"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20957847"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term cardiovascular outcomes in men with obstructive sleep apnoea&#8211;hypopnoea with or without treatment with continuous positive airway pressure&#58; an observational study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;M&#46; Marin"
                            1 => "S&#46;J&#46; Carrizo"
                            2 => "E&#46; Vicente"
                            3 => "A&#46;G&#46; Agusti"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(05)71141-7"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2005"
                        "volumen" => "365"
                        "paginaInicial" => "1046"
                        "paginaFinal" => "1053"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15781100"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Obstructive sleep apnea of obese adults&#58; pathophysiology and perioperative airway management"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46; Isono"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/ALN.0b013e31819c74be"
                      "Revista" => array:6 [
                        "tituloSerie" => "Anesthesiology"
                        "fecha" => "2009"
                        "volumen" => "110"
                        "paginaInicial" => "908"
                        "paginaFinal" => "921"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19293689"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "ACC&#47;AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery&#58; a report of the American College of Cardiology&#47;American Heart Association Task Force on Practice Guidelines &#40;Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery&#41;&#58; developed in collaboration with the American Society of Echocardiography&#44; American Society of Nuclear Cardiology&#44; Heart Rhythm Society&#44; Society of Cardiovascular Anesthesiologists&#44; Society for Cardiovascular Angiography and Interventions&#44; Society for Vascular Medicine and Biology&#44; and Society for Vascular Surgery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46;A&#46; Fleisher"
                            1 => "J&#46;A&#46; Beckman"
                            2 => "K&#46;A&#46; Brown"
                            3 => "H&#46; Calkins"
                            4 => "E&#46; Chaikof"
                            5 => "K&#46;E&#46; Fleischmann"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.107.185699"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2007"
                        "volumen" => "116"
                        "paginaInicial" => "e418"
                        "paginaFinal" => "e499"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17901357"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Residual neuromuscular block&#58; lessons unlearned&#46; Part I&#58; Definitions&#44; incidence&#44; and adverse physiologic effects of residual neuromuscular block"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46;S&#46; Murphy"
                            1 => "S&#46;J&#46; Brull"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1213/ANE.0b013e3181da832d"
                      "Revista" => array:6 [
                        "tituloSerie" => "Anesth Analg"
                        "fecha" => "2010"
                        "volumen" => "111"
                        "paginaInicial" => "120"
                        "paginaFinal" => "128"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20442260"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Residual neuromuscular blockade&#58; incidence&#44; assessment&#44; and relevance in the postoperative period"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "G&#46;S&#46; Murphy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Minerva Anestesiol"
                        "fecha" => "2006"
                        "volumen" => "72"
                        "paginaInicial" => "97"
                        "paginaFinal" => "109"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16493386"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fast&#44; systematic&#44; and continuous delirium assessment in hospitalized patients&#58; the nursing delirium screening scale"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;D&#46; Gaudreau"
                            1 => "P&#46; Gagnon"
                            2 => "F&#46; Harel"
                            3 => "A&#46; Tremblay"
                            4 => "M&#46;A&#46; Roy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jpainsymman.2004.07.009"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pain Symptom Manage"
                        "fecha" => "2005"
                        "volumen" => "29"
                        "paginaInicial" => "368"
                        "paginaFinal" => "375"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15857740"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Residual neuromuscular blockade and critical respiratory events in the postanesthesia care unit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "G&#46;S&#46; Murphy"
                            1 => "J&#46;W&#46; Szokol"
                            2 => "J&#46;H&#46; Marymont"
                            3 => "S&#46;B&#46; Greenberg"
                            4 => "M&#46;J&#46; Avram"
                            5 => "J&#46;S&#46; Vender"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1213/ane.0b013e31816d1268"
                      "Revista" => array:6 [
                        "tituloSerie" => "Anesth Analg"
                        "fecha" => "2008"
                        "volumen" => "107"
                        "paginaInicial" => "130"
                        "paginaFinal" => "137"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18635478"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "High STOP-Bang score indicates a high probability of obstructive sleep apnoea"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "F&#46; Chung"
                            1 => "R&#46; Subramanyam"
                            2 => "P&#46; Liao"
                            3 => "E&#46; Sasaki"
                            4 => "C&#46; Shapiro"
                            5 => "Y&#46; Sun"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/bja/aes022"
                      "Revista" => array:7 [
                        "tituloSerie" => "Br J Anaesth"
                        "fecha" => "2012"
                        "volumen" => "108"
                        "paginaInicial" => "768"
                        "paginaFinal" => "775"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22401881"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0140673699065277"
                          "estado" => "S300"
                          "issn" => "01406736"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Identification of patients at risk for postoperative respiratory complications using a preoperative obstructive sleep apnea screening tool and postanesthesia care assessment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "B&#46; Gali"
                            1 => "F&#46;X&#46; Whalen"
                            2 => "D&#46;R&#46; Schroeder"
                            3 => "P&#46;C&#46; Gay"
                            4 => "D&#46;J&#46; Plevak"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/ALN.0b013e31819b5d70"
                      "Revista" => array:7 [
                        "tituloSerie" => "Anesthesiology"
                        "fecha" => "2009"
                        "volumen" => "110"
                        "paginaInicial" => "869"
                        "paginaFinal" => "877"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19293694"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0016508509001656"
                          "estado" => "S300"
                          "issn" => "00165085"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Derivation and validation of a simple perioperative sleep apnea prediction score"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;K&#46; Ramachandran"
                            1 => "S&#46; Kheterpal"
                            2 => "F&#46; Consens"
                            3 => "A&#46; Shanks"
                            4 => "T&#46;M&#46; Doherty"
                            5 => "M&#46; Morris"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1213/ANE.0b013e3181d489b0"
                      "Revista" => array:6 [
                        "tituloSerie" => "Anesth Analg"
                        "fecha" => "2010"
                        "volumen" => "110"
                        "paginaInicial" => "1007"
                        "paginaFinal" => "1015"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20357144"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A systemic review of obstructive sleep apnea and its implications for anesthesiologists"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46;A&#46; Chung"
                            1 => "H&#46; Yuan"
                            2 => "F&#46; Chung"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1213/ane.0b013e318187c83a"
                      "Revista" => array:6 [
                        "tituloSerie" => "Anesth Analg"
                        "fecha" => "2008"
                        "volumen" => "107"
                        "paginaInicial" => "1543"
                        "paginaFinal" => "1563"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18931212"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association of sleep apnoea with myocardial infarction in men"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46; Hung"
                            1 => "E&#46;G&#46; Whitford"
                            2 => "R&#46;W&#46; Parsons"
                            3 => "D&#46;R&#46; Hillman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "1990"
                        "volumen" => "336"
                        "paginaInicial" => "261"
                        "paginaFinal" => "264"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1973968"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Postoperative hypoxemia in orthopedic patients with obstructive sleep apnea"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;S&#46; Liu"
                            1 => "M&#46;F&#46; Chisholm"
                            2 => "J&#46; Ngeow"
                            3 => "R&#46;S&#46; John"
                            4 => "P&#46; Shaw"
                            5 => "Y&#46; Ma"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s11420-010-9165-0"
                      "Revista" => array:6 [
                        "tituloSerie" => "Hss J"
                        "fecha" => "2011"
                        "volumen" => "7"
                        "paginaInicial" => "2"
                        "paginaFinal" => "8"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22294951"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Reversal from non-depolarising neuromuscular blockade in the postoperative period"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "T&#46; Gaszynski"
                            1 => "L&#46; Szlachcinski"
                            2 => "J&#46; Jakubiak"
                            3 => "W&#46; Gaszynski"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Anestezjol Intens Ter"
                        "fecha" => "2009"
                        "volumen" => "41"
                        "paginaInicial" => "11"
                        "paginaFinal" => "15"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19517671"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Randomized comparison of sugammadex and neostigmine for reversal of rocuronium-induced muscle relaxation in morbidly obese undergoing general anaesthesia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46; Gaszynski"
                            1 => "T&#46; Szewczyk"
                            2 => "W&#46; Gaszynski"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/bja/aer330"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Anaesth"
                        "fecha" => "2012"
                        "volumen" => "108"
                        "paginaInicial" => "236"
                        "paginaFinal" => "239"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22012861"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Preoperative identification of sleep apnea risk in elective surgical patients&#44; using the Berlin questionnaire"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "F&#46; Chung"
                            1 => "B&#46; Ward"
                            2 => "J&#46; Ho"
                            3 => "H&#46; Yuan"
                            4 => "L&#46; Kayumov"
                            5 => "C&#46; Shapiro"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jclinane.2006.08.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Anesth"
                        "fecha" => "2007"
                        "volumen" => "19"
                        "paginaInicial" => "130"
                        "paginaFinal" => "134"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17379126"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/08732159/0000001900000004/v2_201509041415/S0873215913000238/v2_201509041415/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "9575"
    "tipo" => "SECCION"
    "pt" => array:2 [
      "titulo" => "Artigos originais"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "pt"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/08732159/0000001900000004/v2_201509041415/S0873215913000238/v2_201509041415/en/main.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215913000238?idApp=UINPBA00004E"
]

Article information

ISSN: 08732159
Original language: English

DOI:10.1016/j.rppneu.2013.01.003

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 November	10	9	19
2024 October	38	30	68
2024 September	75	44	119
2024 August	63	47	110
2024 July	60	30	90
2024 June	53	38	91
2024 May	51	30	81
2024 April	53	39	92
2024 March	38	28	66
2024 February	47	21	68
2024 January	35	28	63
2023 December	37	22	59
2023 November	32	31	63
2023 October	27	36	63
2023 September	24	26	50
2023 August	23	17	40
2023 July	29	23	52
2023 June	27	10	37
2023 May	46	26	72
2023 April	42	14	56
2023 March	79	26	105
2023 February	58	20	78
2023 January	27	20	47
2022 December	67	17	84
2022 November	56	31	87
2022 October	63	22	85
2022 September	61	29	90
2022 August	83	34	117
2022 July	100	50	150
2022 June	31	24	55
2022 May	57	29	86
2022 April	35	36	71
2022 March	48	59	107
2022 February	40	37	77
2022 January	41	33	74
2021 December	30	40	70
2021 November	42	40	82
2021 October	26	38	64
2021 September	31	33	64
2021 August	22	22	44
2021 July	18	16	34
2021 June	34	25	59
2021 May	35	32	67
2021 April	72	39	111
2021 March	47	27	74
2021 February	76	18	94
2021 January	43	20	63
2020 December	52	17	69
2020 November	55	23	78
2020 October	45	16	61
2020 September	87	33	120
2020 August	120	29	149
2020 July	100	24	124
2020 June	124	22	146
2020 May	114	17	131
2020 April	103	15	118
2020 March	116	16	132
2020 February	116	26	142
2020 January	126	19	145
2019 December	96	30	126
2019 November	133	20	153
2019 October	141	25	166
2019 September	111	17	128
2019 August	215	22	237
2019 July	264	21	285
2019 June	266	17	283
2019 May	257	26	283
2019 April	228	28	256
2019 March	287	27	314
2019 February	282	7	289
2019 January	320	32	352
2018 December	240	6	246
2018 November	91	2	93
2018 October	124	7	131
2018 September	88	9	97
2018 August	171	38	209
2018 July	63	19	82
2018 June	87	22	109
2018 May	84	32	116
2018 April	139	36	175
2018 March	82	29	111
2018 February	41	15	56
2018 January	56	17	73
2017 December	56	25	81
2017 November	82	32	114
2017 October	58	27	85
2017 September	51	19	70
2017 August	39	13	52
2017 July	48	19	67
2017 June	50	22	72
2017 May	86	40	126
2017 April	40	22	62
2017 March	37	23	60
2017 February	126	7	133
2017 January	24	3	27
2016 December	37	26	63
2016 November	43	15	58
2016 October	56	16	72
2016 September	59	21	80
2016 August	24	13	37
2016 July	19	15	34
2016 June	6	19	25
2016 May	4	40	44
2016 April	17	7	24
2016 March	38	120	158
2016 February	37	93	130
2016 January	30	92	122
2015 December	30	11007	11037
2015 November	32	69	101
2015 October	33	69	102
2015 September	29	59	88
2015 August	31	37	68
2015 July	24	34	58
2015 June	17	37	54
2015 May	56	42	98
2015 April	48	52	100
2015 March	44	50	94
2015 February	25	43	68
2015 January	31	31	62
2014 December	37	23	60
2014 November	37	53	90
2014 October	30	42	72
2014 September	35	46	81
2014 August	33	37	70
2014 July	38	53	91
2014 June	28	40	68
2014 May	37	35	72
2014 April	44	44	88
2014 March	78	33	111
2014 February	86	40	126
2014 January	64	35	99
2013 December	66	36	102
2013 November	65	40	105
2013 October	86	37	123
2013 September	88	40	128
2013 August	92	72	164
2013 July	112	62	174

Show all

Indexed in:

Follow us:

Statistics

Indexed in:

Follow us:

Statistics

Subscribe to our newsletter