S801 Impact of Obstructive Sleep Apnea Among Morbidly Obese Adults Undergoing Elective Laparoscopic Sleeve Gastrectomy in the United States

Introduction: Laparoscopic sleeve gastrectomy (LSG), a minimally invasive procedure aimed at improving weight, has gained prominence among morbidly obese patients due to its safety profile and long-term effectiveness. While obstructive sleep apnea (OSA) is a common comorbidity prevalent among morbidly obese adults, data exploring its impact on short-term perioperative LSG outcomes remains understudied. Methods: Pre-tested International Classification of Diseases, Tenth Revision (ICD-10) codes and methodologies (inclusions and exclusions) were applied to identify morbidly obese adults who underwent elective LSG via the National Inpatient Sample (2016-2022). Our sample was divided into OSA and non-OSA patients, and we compared their demographics and complications. We then evaluated the impact of age, sex, comorbidity burden, hospital status, race, and payer form on the composite adverse events among our OSA patients. Results: We identified 630,325 procedures performed between 2016 and 2022, with 35.4% (22,3185) OSA patients. Although both cohorts mainly were women, a higher proportion of men were seen in the OSA group. Additional differences were noted as OSA patients were older, with a higher prevalence of dyslipidemia, smokers, diabetes, chronic kidney disease, chronic obstructive pulmonary disease, hypertension, and liver cirrhosis. Around 1.3% of both groups had a history of prior bariatric surgery. OSA was associated with higher odds of acute respiratory failure (ARF), aspiration pneumonia, need for vasopressors, acute kidney injury (AKI), bleeding/transfusion use, deep vein thrombosis (DVT)/thromboembolism, generalized abdominal pain, postprocedural intestinal obstruction, and all-cause mortality. Major adverse cardiac and cerebrovascular events (MACCE) and generalized acute peritonitis were comparable. In addition, the inflation-adjusted hospital charges were higher among patients with OSA ($59,869 vs $59,144, P < 0.01). Composite adverse events among OSA patients were less likely among women (vs men), private insurance (vs Medicare), rural centers (vs urban teaching and non-teaching), and Hispanics (vs Whites), but with higher odds among Blacks (vs Whites), and with increasing age and comorbidity burden (Charlson Comorbidity Index score). Conclusion: OSA significantly impacts LSG outcomes. These findings support the use of comprehensive preoperative screening and tailored perioperative management in this patient subset.