PURPOSE: The use of polysomnography (PSG) has increased dramatically. In 2004, a multicenter study found the incidence of adverse events (AE) during PSG to be only 0.35%, though only 1 of 17 sites studied was at a major hospital (> 500 beds). We hypothesized that the incidence of AE will depend upon the nature of patient population studied and thus would be higher in a large, urban, hospital-based sleep center.
METHODS: A retrospective study of AE at the hospital-based sleep center at MetroHealth Medical Center, a > 700 bed urban, academic, county hospital, was performed. The sleep center has 8 beds. Data were collected from October 1, 2005 thru March 31, 2006. AE were defined by episodes requiring protocol-driven immediate medical evaluation by the Admitting Medical Officer (AMO), the emergency department (ED), or when an urgent non-sleep evaluation was requested upon review of the PSG. Data were collected regarding demographics and the nature / outcome of AE. Data were analyzed in SPSS.
RESULTS: Of 1128 studies performed, the mortality rate up to two weeks afterwards was 0%. The overall rate of AE was 2.65% (30/1128). The AMO was called in 28/30 cases. Six patients (0.5% of all PSGs) were admitted (2 chest pain, 3 arrhythmias, 1 hypoxia, 1 fall with hip fracture). Three patients were sent to the ED (1 wheezing, 1 ankle fracture, 1 epigastric pain). Of the AE that were deemed stable to return home, 67% had an arrhythmia, 14% had chest pain, and the remainder consisted of hypoglycemia, anxiety, hypoxia, and hematuria. Comparing the AE group to the remainder of the PSG population, there were no differences with regards to gender, BMI, or ethnicity, though the AE group was significantly older (56.9 vs. 49.0 years old, p<0.01).
CONCLUSION: The rate of AE in a sleep center is likely dependent upon the specific patient population being studied.
CLINICAL IMPLICATIONS: Sleep centers need to have procedures in place for handling AE.
DISCLOSURE: Javaad Khan, None.