The suitability of ambulatory surgery for patients with OSA remains controversial, while national guidelines call for more scientific evidence. This study retropsectively investigated the association between OSA status (STOP-BANG or diagnosis) and postoperative outcomes in ambulatory cancer surgery patients at the Josie Robertson Surgery Center of the Memorial Sloan Kettering Center. Surgeries included more complex ambulatory extended recovery procedures for which patients typically stay overnight, such as mastectomy, thyroidectomy, and minimally invasive hysterectomy, prostatectomy, and nephrectomy, as well as typical outpatient surgeries.
No difference was observed in length of stay regardless of OSA status or outpatient versus ambulatory extended recovery procedures. Though a greater frequency of postoperative respiratory events were reported in high-risk/diagnosed OSA patients, the rate of hospital transfer was not significantly different between the groups (risk difference, 0.78%; 95% CI, -0.43% to 2%). On multivariable analysis, there was no evidence of increased rate of urgent care center visits (adjusted risk difference, 1.4%; 95% CI, -0.68% to 3.4%; P = .15) or readmissions within 30 days (adjusted risk difference, 1.2%; 95% CI, -0.40% to 2.8%; P = .077) regardless of OSA status. These results support the notion that patients with moderate-to high-OSA risk, or diagnosed OSA can safely undergo outpatient and advanced ambulatory oncology surgery without the increased health care burden of extended stay or hospital admission while avoiding adverse postoperative outcomes.