Prevalence of undiagnosed obstructive sleep apnea among adult surgical patients in an academic medical center

Kevin J. Finkel, Adam C. Searleman, Heidi Tymkew, Christopher Y. Tanaka, Leif Saager, Elika Safer-Zadeh, Michael Bottros, Jacqueline A. Selvidge, Eric Jacobsohn, Debra Pulley, Stephen Duntley, Colleen Becker, Michael S. Avidan

Research output: Contribution to journalArticle

231 Citations (Scopus)

Abstract

Background: Obstructive sleep apnea (OSA) affects approximately 20% of US adults, of whom about 90% are undiagnosed. While OSA may increase risk of perioperative complications, its prevalence among surgical patients is unknown. We tested the feasibility of screening surgical patients for OSA and determined the prevalence of undiagnosed OSA. Methods: In a prospective, observational study adult surgical patients were screened for OSA in an academic hospital. Patients without an OSA diagnosis who screened high-risk were offered a home sleep study to determine if they had OSA. The results were compared with polysomnography (PSG) when available. Charts of high-risk patients were examined for postoperative complications. High-risk patients received targeted interventions as part of a hospital safety initiative. Results: There were 2877 patients screened; 661 (23.7%) screened high-risk for OSA, of whom 534 (81%) did not have diagnosed OSA. The portable sleep study detected OSA in 170/207 (82%) high-risk patients without diagnosed OSA. Twenty-six PSGs confirmed OSA in 19 of these patients. Postoperatively there were no respiratory arrests, two unanticipated ICU admissions, and five documented respiratory complications. Conclusion: Undiagnosed OSA is prevalent in adult surgical patients. Implementing universal screening is feasible and can identify undiagnosed OSA in many surgical patients. Further investigation is needed into perioperative complications and their prevention for patients with undiagnosed OSA.

Original languageEnglish (US)
Pages (from-to)753-758
Number of pages6
JournalSleep Medicine
Volume10
Issue number7
DOIs
StatePublished - Aug 2009
Externally publishedYes

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Obstructive Sleep Apnea
Sleep
Polysomnography
Observational Studies

Keywords

  • Obstructive sleep apnea
  • Perioperative safety
  • Screening
  • Surgical patients

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Prevalence of undiagnosed obstructive sleep apnea among adult surgical patients in an academic medical center. / Finkel, Kevin J.; Searleman, Adam C.; Tymkew, Heidi; Tanaka, Christopher Y.; Saager, Leif; Safer-Zadeh, Elika; Bottros, Michael; Selvidge, Jacqueline A.; Jacobsohn, Eric; Pulley, Debra; Duntley, Stephen; Becker, Colleen; Avidan, Michael S.

In: Sleep Medicine, Vol. 10, No. 7, 08.2009, p. 753-758.

Research output: Contribution to journalArticle

Finkel, KJ, Searleman, AC, Tymkew, H, Tanaka, CY, Saager, L, Safer-Zadeh, E, Bottros, M, Selvidge, JA, Jacobsohn, E, Pulley, D, Duntley, S, Becker, C & Avidan, MS 2009, 'Prevalence of undiagnosed obstructive sleep apnea among adult surgical patients in an academic medical center', Sleep Medicine, vol. 10, no. 7, pp. 753-758. https://doi.org/10.1016/j.sleep.2008.08.007
Finkel, Kevin J. ; Searleman, Adam C. ; Tymkew, Heidi ; Tanaka, Christopher Y. ; Saager, Leif ; Safer-Zadeh, Elika ; Bottros, Michael ; Selvidge, Jacqueline A. ; Jacobsohn, Eric ; Pulley, Debra ; Duntley, Stephen ; Becker, Colleen ; Avidan, Michael S. / Prevalence of undiagnosed obstructive sleep apnea among adult surgical patients in an academic medical center. In: Sleep Medicine. 2009 ; Vol. 10, No. 7. pp. 753-758.
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abstract = "Background: Obstructive sleep apnea (OSA) affects approximately 20{\%} of US adults, of whom about 90{\%} are undiagnosed. While OSA may increase risk of perioperative complications, its prevalence among surgical patients is unknown. We tested the feasibility of screening surgical patients for OSA and determined the prevalence of undiagnosed OSA. Methods: In a prospective, observational study adult surgical patients were screened for OSA in an academic hospital. Patients without an OSA diagnosis who screened high-risk were offered a home sleep study to determine if they had OSA. The results were compared with polysomnography (PSG) when available. Charts of high-risk patients were examined for postoperative complications. High-risk patients received targeted interventions as part of a hospital safety initiative. Results: There were 2877 patients screened; 661 (23.7{\%}) screened high-risk for OSA, of whom 534 (81{\%}) did not have diagnosed OSA. The portable sleep study detected OSA in 170/207 (82{\%}) high-risk patients without diagnosed OSA. Twenty-six PSGs confirmed OSA in 19 of these patients. Postoperatively there were no respiratory arrests, two unanticipated ICU admissions, and five documented respiratory complications. Conclusion: Undiagnosed OSA is prevalent in adult surgical patients. Implementing universal screening is feasible and can identify undiagnosed OSA in many surgical patients. Further investigation is needed into perioperative complications and their prevention for patients with undiagnosed OSA.",
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AU - Finkel, Kevin J.

AU - Searleman, Adam C.

AU - Tymkew, Heidi

AU - Tanaka, Christopher Y.

AU - Saager, Leif

AU - Safer-Zadeh, Elika

AU - Bottros, Michael

AU - Selvidge, Jacqueline A.

AU - Jacobsohn, Eric

AU - Pulley, Debra

AU - Duntley, Stephen

AU - Becker, Colleen

AU - Avidan, Michael S.

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N2 - Background: Obstructive sleep apnea (OSA) affects approximately 20% of US adults, of whom about 90% are undiagnosed. While OSA may increase risk of perioperative complications, its prevalence among surgical patients is unknown. We tested the feasibility of screening surgical patients for OSA and determined the prevalence of undiagnosed OSA. Methods: In a prospective, observational study adult surgical patients were screened for OSA in an academic hospital. Patients without an OSA diagnosis who screened high-risk were offered a home sleep study to determine if they had OSA. The results were compared with polysomnography (PSG) when available. Charts of high-risk patients were examined for postoperative complications. High-risk patients received targeted interventions as part of a hospital safety initiative. Results: There were 2877 patients screened; 661 (23.7%) screened high-risk for OSA, of whom 534 (81%) did not have diagnosed OSA. The portable sleep study detected OSA in 170/207 (82%) high-risk patients without diagnosed OSA. Twenty-six PSGs confirmed OSA in 19 of these patients. Postoperatively there were no respiratory arrests, two unanticipated ICU admissions, and five documented respiratory complications. Conclusion: Undiagnosed OSA is prevalent in adult surgical patients. Implementing universal screening is feasible and can identify undiagnosed OSA in many surgical patients. Further investigation is needed into perioperative complications and their prevention for patients with undiagnosed OSA.

AB - Background: Obstructive sleep apnea (OSA) affects approximately 20% of US adults, of whom about 90% are undiagnosed. While OSA may increase risk of perioperative complications, its prevalence among surgical patients is unknown. We tested the feasibility of screening surgical patients for OSA and determined the prevalence of undiagnosed OSA. Methods: In a prospective, observational study adult surgical patients were screened for OSA in an academic hospital. Patients without an OSA diagnosis who screened high-risk were offered a home sleep study to determine if they had OSA. The results were compared with polysomnography (PSG) when available. Charts of high-risk patients were examined for postoperative complications. High-risk patients received targeted interventions as part of a hospital safety initiative. Results: There were 2877 patients screened; 661 (23.7%) screened high-risk for OSA, of whom 534 (81%) did not have diagnosed OSA. The portable sleep study detected OSA in 170/207 (82%) high-risk patients without diagnosed OSA. Twenty-six PSGs confirmed OSA in 19 of these patients. Postoperatively there were no respiratory arrests, two unanticipated ICU admissions, and five documented respiratory complications. Conclusion: Undiagnosed OSA is prevalent in adult surgical patients. Implementing universal screening is feasible and can identify undiagnosed OSA in many surgical patients. Further investigation is needed into perioperative complications and their prevention for patients with undiagnosed OSA.

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KW - Perioperative safety

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