The guideline committee has made the following recommendations for research.
a) Does preoperative screening of people who are at risk of obstructive sleep apnoea with polysomnography identify those at higher risk of postoperative complications?
b) Does treating obstructive sleep apnoea perioperatively improve outcomes?
Obstructive sleep apnoea is a common condition, particularly in people who are obese, and is associated with adverse postoperative outcomes. However, it is frequently undiagnosed before surgery. Work is ongoing to examine whether obstructive sleep apnoea is associated with a variety of postoperative outcomes (morbidity, mortality, quality of life) in specific surgical populations. However, there is currently no robust evidence or any ongoing trials studying whether preoperative assessment and diagnosis of obstructive sleep apnoea leads to preoperative intervention or improved postoperative outcomes.
Does optimisation of HbA1c in people with poorly controlled diabetes improve surgical outcomes?
Diabetes is the most common metabolic disorder in the UK and people with diabetes increasingly need surgical procedures. Diabetes leads to increased morbidity, length of stay and inpatient costs. Evidence suggests that doctors often fail to identify high‑risk patients before surgery and do not provide perioperative interventions to control HbA1c levels. However, the impact of optimising HbA1c levels before surgery has not been assessed in a randomised clinical trial.