PURPOSE: To identify all inpatients at risk for having obstructive sleep apnea (OSA) using the adjusted neck circumference score and evaluate whether screening inpatients for risk of OSA reduced in-hospital complications related to OSA.
METHODS: This is an observational study utilizing the adjusted neck circumference screening score. In October 2006, Georgetown University Hospital initiated a RN/RT-driven protocol to screen adult inpatients for OSA. If the patients do not have a prior history of OSA, they are screened using the adjusted neck circumferences score: neck circumference (#cm=#points), history of hypertension (4 points), history of snoring (3 points), history of night-time choking or gasping (3 points). If they have a preexisting history of OSA or a screening score > 48, a purple ID band is placed to identify them. The patient with a score >48 is then placed on continuous pulse oximetry to monitor for desaturation.
RESULTS: To date, a total of 491 patients with previously unknown OSA status have been screened for OSA: 354 (72.1%) male, 137 (27.9%) female, and average score of 51.0 + 4.7. 391 (79.6%) patients had a score > 48. With regard to gender, male patients had an average age of 55.1 + 12.9 years, and an average score of 51.6 + 4.3 (85.0% score >48). Female patients had an average age of 53.8 + 14.1, and an average score 49.4 + 5.3 (65.7% score > 48). Since this screening and banding have been initiated, there have been no adverse events associated with OSA.
CONCLUSION: This observational study shows that a high percentage of adult inpatients are at high risk for OSA.
CLINICAL IMPLICATIONS: Given the large number of adult inpatients at risk of OSA, increasing awareness and developing protocols for who should undergo polysomnography are essential.
DISCLOSURE: Christopher Wyckoff, No Financial Disclosure Information; No Product/Research Disclosure Information