Hospital outcomes in non-surgical patients identified at risk for OSA
dc.contributor.author | Khan, Sikandar H. | |
dc.contributor.author | Manchanda, Shalini | |
dc.contributor.author | Sigua, Ninotchka L. | |
dc.contributor.author | Green, Erika | |
dc.contributor.author | Mpofu, Philani B. | |
dc.contributor.author | Hui, Siu | |
dc.contributor.author | Khan, Babar A. | |
dc.contributor.department | Medicine, School of Medicine | en_US |
dc.date.accessioned | 2022-06-28T18:36:34Z | |
dc.date.available | 2022-06-28T18:36:34Z | |
dc.date.issued | 2020 | |
dc.description.abstract | Background: In-hospital respiratory outcomes of non-surgical patients with undiagnosed obstructive sleep apnea (OSA), particularly those with significant comorbidities are not well defined. Undiagnosed and untreated OSA may be associated with increased cardiopulmonary morbidity. Study objectives: Evaluate respiratory failure outcomes in patients identified as at-risk for OSA by the Berlin Questionnaire (BQ). Methods: This was a retrospective study conducted using electronic health records at a large health system. The BQ was administered at admission to screen for OSA to medical-service patients under the age of 80 years old meeting the following health system criteria: (1) BMI greater than 30; (2) any of the following comorbid diagnoses: hypertension, heart failure, acute coronary syndrome, pulmonary hypertension, arrhythmia, cerebrovascular event/stroke, or diabetes. Patients with known OSA or undergoing surgery were excluded. Patients were classified as high-risk or low-risk for OSA based on the BQ score as follows: low-risk (0 or 1 category with a positive score on the BQ); high-risk (2 or more categories with a positive score on BQ). The primary outcome was respiratory failure during index hospital stay defined by any of the following: orders for conventional ventilation or intubation; at least two instances of oxygen saturation less than 88% by pulse oximetry; at least two instances of respiratory rate over 30 breaths per minute; and any orders placed for non-invasive mechanical ventilation without a previous diagnosis of sleep apnea. Propensity scores were used to control for patient characteristics. Results: Records of 15,253 patients were assessed. There were no significant differences in the composite outcome of respiratory failure by risk of OSA (high risk: 11%, low risk: 10%, p = 0.55). When respiratory failure was defined as need for ventilation, more patients in the low-risk group experienced invasive mechanical ventilation (high-risk: 1.8% vs. low-risk: 2.3%, p = 0.041). Mortality was decreased in patients at high-risk for OSA (0.86%) vs. low risk for OSA (1.53%, p < 0.001). Conclusions: Further prospective studies are needed to understand the contribution of undiagnosed OSA to in-hospital respiratory outcomes. | en_US |
dc.eprint.version | Author's manuscript | en_US |
dc.identifier.citation | Khan SH, Manchanda S, Sigua NL, et al. Hospital outcomes in non-surgical patients identified at risk for OSA. Heart Lung. 2020;49(2):112-116. doi:10.1016/j.hrtlng.2019.12.001 | en_US |
dc.identifier.uri | https://hdl.handle.net/1805/29441 | |
dc.language.iso | en_US | en_US |
dc.publisher | Elsevier | en_US |
dc.relation.isversionof | 10.1016/j.hrtlng.2019.12.001 | en_US |
dc.relation.journal | Heart & Lung | en_US |
dc.rights | Publisher Policy | en_US |
dc.source | PMC | en_US |
dc.subject | Sleep | en_US |
dc.subject | Obstructive sleep apnea | en_US |
dc.subject | Health outcomes | en_US |
dc.subject | Respiratory failure | en_US |
dc.title | Hospital outcomes in non-surgical patients identified at risk for OSA | en_US |
dc.type | Article | en_US |