PURPOSE: Obstructive Sleep Apnea (OSA) has been associated with complications in the perioperative setting. Nonsurgical hospitalized patients often have co-morbidities associated with OSA and likely represent a population enriched for OSA. We hypothesized that hospitalized patients with OSA and at-risk for OSA would more frequently have cardiopulmonary complications compared to patients at low risk for OSA.
METHODS: Over 4 months, a convenience sample of general medicine floor admissions at an urban academic center were surveyed to determine if they had a diagnosis of OSA or would be considered at-risk for OSA. At-risk for OSA patients had to be positive by both the STOP and the Berlin questionnaires. The electronic medical records were reviewed for cardiopulmonary complications and length of stay (LOS).
RESULTS: Two hundred and eighteen of 311 patients (70%) approached agreed to participate. OSA was a known diagnosis in 35 (16%), at-risk for OSA was considered in 107 (49%), and the remaining 76 (35%) were considered low risk. Complications were noted in 40% with OSA (p=0.003 vs. low risk), 21% at-risk for OSA (p=0.23 vs. low risk) and 14% at low risk for OSA. After adjusting for age and co-morbidities, complication rates in at-risk vs. low risk became significant (p=0.002). The use of IV narcotics did not appear to affect the rate of complications. The LOS was shorter in low risk (3.2+/−3.4 days) than at-risk (3.6+/−3.6 days) and OSA (3.6+/−4.7 days) patients, but this was not significant.
CONCLUSION: Diagnosed OSA is common in hospitalized patients and there appears to be an additional group of hospitalized patients at-risk for OSA. Those with OSA and those at-risk for OSA have more frequent cardiopulmonary complications while hospitalized, though the mechanism for this is not known.
CLINICAL IMPLICATIONS: Hospitalized patients with OSA should be considered a high risk group for cardiopulmonary complications. Screening for OSA in patients admitted to the hospital is an issue that warrants further study.
DISCLOSURE: Dennis Auckley, No Financial Disclosure Information; No Product/Research Disclosure Information