Sleep Disorders |

Consciously Sedating: A Retrospective Study Evaluating Clinical Outcomes in Patients With Sleep Apnea Who Underwent Conscious Sedation for Endoscopy FREE TO VIEW

Lakshmi Mudambi, MD; Duncan Geron, MS; Jennifer Katigbak; Andrew Spiegelman, PhD; Yassir Shaib, MD; Max Hirshkowitz, PhD; Charlie Lan, DO; Suryakanta Velamuri, MD; Amir Sharafkhaneh, MD
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Baylor College of Medicine, Houston, TX

Chest. 2015;148(4_MeetingAbstracts):1053A. doi:10.1378/chest.2226819
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SESSION TITLE: Sleep Disorders Posters I: Diagnosis

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: To determine if presence of obstructive sleep apnea (OSA) diagnosis predicts higher hospitalization in patients who underwent colonoscopy under moderate conscious sedation (MCS).

METHODS: We conducted a retrospective database review of patients who underwent an elective, ambulatory colonoscopy under MCS at Michael E. DeBakey VA Medical Center from 1999 to 2012. The OSA group had diagnosis with polysomnography. The control group consisted of patients without any sleep related ICD-9 diagnostic code. Demographics, comorbidities, and health care utilization subsequent to the procedure including admissions to the ER, hospital and ICU in the first 24 hours, 7 days, 30 days, 90 days and 1 year after the colonoscopy were extracted.

RESULTS: We compared 983 OSA patients (mean apnea-hypopnea index [AHI]=35.4 + 27.7) to 2374 controls. The OSA group was younger (60.1 + 7.9 vs. 61.2 + 9.9; p < 0.001), more male (95.2% vs. 91.1%; p <0.0001) and had higher BMI (36.4 + 8.1 vs 30.2 + 6.7; p<0.0001) and Charlson comorbidity index (1.96 + 2.02 vs. 1.49 + 1.83; p<0.001). OSA group carried more cardiovascular comorbid diagnosis compared to control. Hospitalizations and ICU admissions did not differ between the two study groups. Within the OSA group, hospitalization, ER visits, or ICU admissions did not differ comparing patients with AHI <5 was compared to AHI >30. Compared to controls, hospitalization by day 7 and 1 year and ER visits at 1 year were significantly higher in OSA patients with AHI >50.

CONCLUSIONS: In patients with OSA, hospital and ICU admissions in the 24 hours, 7 days, 30 days, 90 days and 1 year after a colonoscopy with moderate conscious sedation did not differ from patients without any sleep related disorders except in patients with AHI >50.

CLINICAL IMPLICATIONS: Risks of moderate conscious sedation in patients with OSA for ambulatory procedures are minimized with proper perioperative monitoring.

DISCLOSURE: The following authors have nothing to disclose: Lakshmi Mudambi, Duncan Geron, Jennifer Katigbak, Andrew Spiegelman, Yassir Shaib, Max Hirshkowitz, Charlie Lan, Suryakanta Velamuri, Amir Sharafkhaneh

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