Diagnosis and Treatment of Sleep Disordered Breathing in Hospitalized Cardiac Patients: A Reduction in 30-Day Hospital Readmission Rates

Kauta, Shilpa R.; Keenan, Brendan T.; Goldberg, Lee R.; Schwab, Richard J.

doi:10.5664/jcsm.4096

Cited by 74 publications

(49 citation statements)

References 39 publications

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“…Recognizing this condition in a timely and efficient manner may lead to fewer readmissions and ultimately reduce costs for this at-risk population. 22 The STOP questionnaire was used because of its recognized clinical validity among pre-operative surgical patients, simple format, interpretability, low cost, and ability to be self-administered. 23 Our preliminary results indicate significantly improved yield at a lower cost by combining the STOP questionnaire (high sensitivity) with overnight pulse oximetry (high specificity) testing.…”

Section: Discussionmentioning

confidence: 99%

Obstructive Sleep Apnea in Obese Hospitalized Patients: A Single Center Experience

Sharma

Mather

Efird

et al. 2015

Journal of Clinical Sleep Medicine

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Section: Discussionmentioning

confidence: 99%

Obstructive Sleep Apnea in Obese Hospitalized Patients: A Single Center Experience

Sharma

Mather

Efird

et al. 2015

Journal of Clinical Sleep Medicine

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“…6,7 Recent data suggest that early recognition of SDB in CHF patients and subsequent intervention can reduce hospital readmissions. 8,9 Although hospitalized patients with CHF present a unique opportunity for screening and diagnosing SDB, they are rarely screened or evaluated. This is partly due to low awareness, lack of expertise for evaluation, and major costs associated with performing traditional polysomnography (PSG) in hospitalized settings.…”

Section: Introductionmentioning

confidence: 99%

Sleep Overnight Monitoring for Apnea in Patients Hospitalized with Heart Failure (SOMA-HF Study)

Sharma

Mather

Chowdhury

et al. 2017

Journal of Clinical Sleep Medicine

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Introduction: Sleep-disordered breathing (SDB) is highly prevalent in hospitalized patients with congestive heart failure (CHF) and the condition is diagnosed and treated in only a minority of these patients. Portable monitoring (PM) is a screening option, but due to costs and the expertise required, many hospitals may find it impractical to implement. We sought to test the utility of an alternative approach for screening hospitalized CHF patients for SDB, high-resolution pulse oximetry (HRPO). Methods: We conducted a prospective controlled trial of 125 consecutive patients admitted to the hospital with CHF. Simultaneous PM and HRPO for a single night was performed. All but one patient were monitored on breathing room air. The HRPO-derived ODI (oxygen desaturation index) was compared with PM-derived respiratory event index (REI) using both receiver operator characteristic (ROC) curve analysis and a Bland-Altman plot. Results: Of 105 consecutive CHF patients with analyzable data, 61 (58%) were males with mean age of 64.9 ± 15.1 years and mean body mass index of 30.3 ± 8.3 kg/m 2 . Of the 105 patients, 10 (9.5%) had predominantly central sleep apnea (central events > 50% of the total events), although central events were noted in 42 (40%) of the patients. The ROC analysis showed an area under the curve of 0.89 for REI > 5 events/h. The Bland-Altman plot showed acceptable agreement with 95% limits of agreement between −28.5 to 33.7 events/h and little bias. Conclusions:We conclude that high-resolution pulse oximetry is a simple and cost-effective screening tool for SDB in CHF patients admitted to the hospital. Such screening approaches may be valuable for large-scale implementation and for the optimal design of interventional trials. Keywords: decompensated congestive heart failure, early diagnosis, high-resolution pulse oximetry, hospitalized patients, lung, portable monitoring, sleepdisordered breathing Citation: Sharma S, Mather PJ, Chowdhury A, Gupta S, Mukhtar U, Willes L, Whellan DJ, Malhotra A, Quan SF. Sleep overnight monitoring for apnea in patients hospitalized with heart failure (SOMA-HF Study). J Clin Sleep Med. 2017;13(10):1185-1190. I NTRO DUCTI O NCongestive heart failure (CHF) is the most common cause of hospital admissions and readmissions in the United States.1 Despite identifying and mitigating several risk factors for CHF decompensation, readmissions for decompensated heart failure remain unacceptably high.2 As a result, efforts are ongoing to find ways to reduce readmissions related to CHF.Studies have shown that patients with untreated sleep-disordered breathing (SDB) are at increased risk of heart failure, and untreated SDB in CHF is independently associated with higher mortality.3,4 The implications of these findings are considerable, because SDB is highly prevalent 5,6 and also highly underrecognized and under-treated in patients with CHF.6,7 Recent data suggest that early recognition of SDB in CHF patients and subsequent intervention can reduce hospital readmissions. 8,9Although hospitaliz...

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“…Small studies showed that CPAP in patients with HF and OSA reduced 30-day hospital readmission and emergency visits. 128 It also improved systolic function, blood pressure, and heart rate. [129][130][131] In long-term studies, CPAP decreased mortality and improved hospitalization-free survival in patients with HF and OSA.…”

Section: Early Treatment Of Obstructive Sleep Apnea In Cardiovascularmentioning

confidence: 99%

Rehabilitation of Cardiovascular Disorders and Sleep Apnea

Jafari

2017

Sleep Medicine Clinics

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Diagnosis and Treatment of Sleep Disordered Breathing in Hospitalized Cardiac Patients: A Reduction in 30-Day Hospital Readmission Rates

Cited by 74 publications

References 39 publications

Obstructive Sleep Apnea in Obese Hospitalized Patients: A Single Center Experience

Obstructive Sleep Apnea in Obese Hospitalized Patients: A Single Center Experience

Sleep Overnight Monitoring for Apnea in Patients Hospitalized with Heart Failure (SOMA-HF Study)

Rehabilitation of Cardiovascular Disorders and Sleep Apnea

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