Sleep Disorders |

A Prospective Study of the Incidence and Complications of Obstructive Sleep Apnea (OSA) in Patients Undergoing Total Joint Arthroplasty (TJA) FREE TO VIEW

Srinidhi Subraya Bhat*, MBBS; Sanjay Pai, MS; Lakshmi Priya Srinivasan, MBBS; Ravindra Mehta, MD
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Fortis Hospitals, Bangalore, India

Chest. 2012;142(4_MeetingAbstracts):1048A. doi:10.1378/chest.1389426
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PRESENTED ON: Sunday, October 21, 2012 at 10:30 AM - 11:45 AM

PURPOSE: There is scant data on the prevalence of OSA in India, and even less on the prevalence in specific sub-populations. Total joint (knee and hip) arthroplasty is on the rise, and these patients often have other risk factors for OSA such as obesity. This prospective study defines the prevalence and impact of OSA on the peri-operative care of these patients.

METHODS: 450 patients undergoing TJA over 3.5 years were screened for OSA using the Berlin (BQ) and Epworth questionnaires (ESS). Other parameters like neck circumference, Mallampatti score, and BMI were recorded.

RESULTS: There were 128 (28.4%) males and 322 (71.5%) females in the study. 193/450 (42.8%) patients, 54/128 (42.1%) males and 139/322 (43.1%) females were found to be high risk for OSA, according to the BQ. 108/193 (55.9%) patients at high risk for OSA had a BMI more than 30 Kg/m2. Using the ESS, 32/450 (7.1%) patients were at high risk for OSA, indicating a difference between the BQ and ESS for screening of OSA. Assessing peri-operative complications, 15/193 (7.7%) had atelectasis requiring supplemental O2 and delaying mobilization. There were no other significant problems

CONCLUSIONS: (1) The prevalence of OSA as assessed by the BQ is significantly high (42.8%) in a TJA population in India, beyond what can be explained by the BMI. This is much higher than the prior mentioned prevalence in a general referral population (20%). (2) The incidence of OSA was similar in males and females. (3) There were mild peri - operative complications, predominantly atelectasis. (4) The significant discrepancy between the BQ and ESS in stratifying these patients could be due to the limited applicability of some of the ESS questions to the Indian population

CLINICAL IMPLICATIONS: This is the first Indian study, and one of the few worldwide studies to define the incidence and complications of OSA in the TJA population. Clinicians should be aware of the high incidence of OSA and implications in these patients

DISCLOSURE: The following authors have nothing to disclose: Srinidhi Subraya Bhat, Sanjay Pai, Lakshmi Priya Srinivasan, Ravindra Mehta

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Fortis Hospitals, Bangalore, India




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