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Sleep Disorders |

Adherence of Inpatients Suspected of Sleep Disordered Breathing to Polysomnography and Noninvasive Ventilation after Hospital Discharge

Diana Alexandru*, DO; Stephen Gorman, DO
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Maine Medical Center, Portland, ME


Chest. 2012;142(4_MeetingAbstracts):1071A. doi:10.1378/chest.1390632
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Abstract

SESSION TYPE: Sleep Posters

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: Adherence of outpatients with diagnosed sleep disordered breathing (SDB) to nocturnal noninvasive ventilation (NIV) is approximately 46%-80%. We evaluated the adherence to testing and therapy of inpatients suspected of SDB after discharge.

METHODS: IRB approval was obtained. We included inpatients suspected of SDB by consulting pulmonologists, admitted between January 1st 2008 and December 31st 2010. All patients had a scheduled PSG at discharge. Patients with prior known SBD, <18 or >90 years, or with terminal disease were excluded. A retrospective chart review of existing inpatient, sleep center, and outpatient medical records was performed. Adherence to NIV was defined as a subjective or objective report of using NIV routinely. Data were analyzed using multivariate logistic regression model.

RESULTS: 84 inpatients were included: mean age 65, BMI 37, 60% men, 98% Caucasians. 39/84 patients (46%) underwent outpatient PSG as advised, 32/39 (82%) had AHI >5 events/hour, with NIV recommended. 3 months adherence with NIV was 50% (16/32). 12 months adherence was 39% (12/31). Factors associated with PSG follow up was presence of private insurance (OR 6.39, 95% CI: 1.15-35.72). Older patients were more likely to be compliant with NIV at both 3 months (OR 1.12, 95% CI: 1.02, 1.22) and 12 months (OR 1.10, 95% CI: 1.01, 1.18)

CONCLUSIONS: Patients suspected of SDB during hospitalization had low rates of outpatient polysomnography, even when the follow up was arranged. Most patients suspected by pulmonary consultants of SDB in fact required NIV, but short and long term adherence to NIV was low.

CLINICAL IMPLICATIONS: Further evaluation of barriers to PSG and NIV utilization, and a quality improvement initiative to address these deficiencies, is warranted.

DISCLOSURE: The following authors have nothing to disclose: Diana Alexandru, Stephen Gorman

No Product/Research Disclosure Information

Maine Medical Center, Portland, ME

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