Obstructive Sleep Apnea is an Independent Risk Factor for Hospital Readmission

Scalzitti, Nicholas J; O’Connor, Peter; Nielsen, Skyler W.; Aden, James K; Brock, Matthew S; Taylor, David; Mysliwiec, Vincent; Dion, Gregory R.

doi:10.5664/jcsm.7098

Cited by 27 publications

(15 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The study did, however, find an association between calcification and OSA, when calcification was measured by segment involvement score and segment stenosis score. A US study of general medicine patients reported OSA as a risk factor for readmission (11.4% vs. 7.6%, p < 0.01) [31]. Thus, OSA may be an important novel modifiable risk factor for cardiovascular readmissions.…”

Section: Sleep and Readmissionsmentioning

confidence: 99%

The Association between Sleep Duration and Quality with Readmissions: An Exploratory Pilot-Study among Cardiology Inpatients

et al. 2020

View full text Add to dashboard Cite

Background: Readmissions within 30 days of discharge are prominent among patients with cardiovascular disease. Post hospital syndrome hypothesizes that sleep disturbance during the index admission contributes to an acquired transient vulnerability, leading to increased risk of readmission. This study evaluated the association of in-hospital sleep (a) duration and (b) quality with 30-day all-cause unplanned readmission. Methods: This prospective observational cohort study included patients admitted to the coronary care unit of a South Australian hospital between 2016–2018. Study participants were invited to wear an ActiGraph GT3X+ for the duration of their admission and for two weeks post-discharge. Validated sleep and quality of life questionnaires, including the Pittsburgh Sleep Quality Index (PSQI), were administered. Readmission status and questionnaires were assessed at 30 days post-discharge via patient telephone interview and a review of hospital records. Results: The final cohort consisted of 75 patients (readmitted: n = 15, non-readmitted: n = 60), of which 72% were male with a mean age 66.9 ± 13.1 years. Total sleep time (TST), both in hospital (6.9 ± 1.3 vs. 6.8 ± 2.9 h, p = 0.96) and post-discharge (7.4 ± 1.3 h vs. 8.9 ± 12.6 h, p = 0.76), was similar in all patients. Patient’s perception of sleep, reflected by PSQI scores, was poorer in readmitted patients (9.13 ± 3.6 vs. 6.4 ± 4.1, p = 0.02). Conclusions: Although an association between total sleep time and 30-day readmission was not found, patients who reported poorer sleep quality were more likely to be readmitted within 30 days. This study also highlighted the importance of improving sleep, both in and out of the hospital, to improve the outcomes of cardiology inpatients.

show abstract

Section: Sleep and Readmissionsmentioning

confidence: 99%

The Association between Sleep Duration and Quality with Readmissions: An Exploratory Pilot-Study among Cardiology Inpatients

et al. 2020

View full text Add to dashboard Cite

show abstract

“…[7][8][9] Patients with OSA are known to have difficulties with intubation, more frequent admissions to the intensive care unit (ICU), more postoperative complications, longer duration of hospital stay, and increased hospital readmission. 2,3,[10][11][12][13][14] Undiagnosed and/or untreated sleep apnea can lead to adverse events and morbidity in hospitalized patients receiving care for other illnesses or injuries. Hospitals often deploy a rapid response or medical emergency team (MET) when patients show signs of deterioration in order to rapidly identify and intervene to prevent fatal decline in patient status.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of risk for sleep apnea among hospitalized patients who survived a medical emergency team activation

Tang

Spilman

Hahn

et al. 2020

Journal of Clinical Sleep Medicine

View full text Add to dashboard Cite

Study Objectives: Sleep-disordered breathing (SDB) is a common disorder that causes people to stop breathing in their sleep, and obstructive sleep apnea (OSA) is the most common form of SDB in the general population. Because OSA is often undiagnosed and undermanaged, it has been associated with adverse events and morbidity in hospitalized patients. The purpose of the study was to evaluate prevalence of OSA risk in a population of patients who survived a medical emergency team (MET) activation during hospitalization. Methods: This prospective study was conducted at a hospital in the Midwest in 2014. Patients who survived a METactivation and consented to participate were administered the STOP-Bang questionnaire and asked other health and lifestyle questions. Review of the medical record was conducted to ascertain patient characteristics, comorbidities, and medications. Differences were assessed using Kruskal-Wallis one-way analysis of variance and the chi-square test.Results: Of 148 study patients, median age was 68 years (interquartile range: 55-78) and 15% were morbidly obese (body mass index ≥ 40 kg/m 2 ). Fifty percent of patients (n = 74) were found to be at high risk for OSA, yet only 38% (n = 28) of those patients received a previous diagnosis of OSA. Variables available in the medical record were highly correlated with the overall STOP-Bang score (r =. 75, P < .001). Conclusions: Half of patients who survived a MET activation during hospitalization screened at high risk for OSA. Standardized screening for risk of sleep apnea, as well as a truncated risk score generated by variables in the medical record, could guide clinical decision making in this at-risk population.

show abstract

“…Obstructive sleep apnea (OSA) is a common condition in subjects from both sex and all ages 1 , 2 , and it is associated with higher morbidity and mortality 3 , 4 . In Brazilian population, the presence of severe OSA (apnea-hypopnea index - AHI≥15) was predictor of hospitalizations and/or demand for emergency services 5 . Recently, Scalzitti et al 5 analyzed more than 22,000 patients to identify factors that contribute to hospital readmission within 30 days of discharge.…”

mentioning

confidence: 99%

“…In Brazilian population, the presence of severe OSA (apnea-hypopnea index - AHI≥15) was predictor of hospitalizations and/or demand for emergency services 5 . Recently, Scalzitti et al 5 analyzed more than 22,000 patients to identify factors that contribute to hospital readmission within 30 days of discharge. Authors found that OSA was an independent risk factor for readmission 5 .…”

mentioning

confidence: 99%

See 1 more Smart Citation

Different approaches to investigate sleep apnea

Andersen

2018

Sleep Sci

View full text Add to dashboard Cite

Different approaches to investigate sleep apnea EDITORIALSleep disorders, in particular sleep apnea, has been recognized as a public health problem. Obstructive sleep apnea (OSA) is a common condition in subjects from both sex and all ages 1,2 , and it is associated with higher morbidity and mortality 3,4 . In Brazilian population, the presence of severe OSA (apnea-hypopnea index -AHI≥15) was predictor of hospitalizations and/or demand for emergency services 5 . Recently, Scalzitti et al. 5 analyzed more than 22,000 patients to identify factors that contribute to hospital readmission within 30 days of discharge. Authors found that OSA was an independent risk factor for readmission 5 .OSA consequences to subjects' health and well-being warranted further investigation of the diverse factors that could interfere with OSA treatment and prognostic. Moreover, the clinical, social and economic burden of sleep disorders indicate the importance to explore OSA with a multidisciplinary perspective and using a broad approach. In this number of Sleep Science, four articles looked into OSA using different approaches, aiming to analyze the associated factors with the disorder risk and severity, and the respective treatments outcomes.We highlight the studies that explored OSA diagnostic and treatment using alternative means. This approach could be helpful in clinical situations with limited/no access to the gold-standartd tools. Kale et al. 6 investigated the association of oral characteristics, as maxillary arch constriction, facial profile and tongue size, with the risk of OSA. Authors applied the STOP-BANG questionnaire in a sample of patients admitted in a specialized hospital for dental treatment. Results demonstrated that the risk of being classified as high risk for OSA was more than 2 times higher in participants that had neck circumference >40cm, Mallampati score class 3 or 4, large tongue, and deep palatal vault. These results are very interesting due to the clinical applicability. The oral parameters analyzed in the study could be used in dental clinical practice as an initial screening of OSA risk, enable to reduce the time for polysomnography exam, diagnosis and treatment. The use of oral and orthodontic evaluations is also applied to OSA treatment.In a Case Report, Guimaraes et al. 7 described a significant improvement in AHI after mandibular advancement device treatment in a CPAP-intolerant male patient. After two years of treatment, patient showed a reduction of the AHI from 80.5 events/h to 8 events/h, in addition to improvements in oxygen saturation parameters and arousal index. The article demonstrates the importance to use alternative therapies to OSA patients with no CPAP adherence.OSA is highly prevalent in society and strongly associated to several comorbidities. Increase the access and the response to OSA treatment, and facilitate the disease diagnostic are challenges in Sleep Medicine. Studies in this field are essential to the discussion and development of new clinical and research strategies.

show abstract

Obstructive Sleep Apnea is an Independent Risk Factor for Hospital Readmission

Abstract: This study found OSA to be an independent risk factor for readmission within 30 days of discharge. PAP therapy appears to be underutilized in patients with known OSA. Additional studies are needed to define the relationship between OSA, PAP adherence, and hospital readmission.

Cited by 27 publications

References 16 publications

The Association between Sleep Duration and Quality with Readmissions: An Exploratory Pilot-Study among Cardiology Inpatients

The Association between Sleep Duration and Quality with Readmissions: An Exploratory Pilot-Study among Cardiology Inpatients

Prevalence of risk for sleep apnea among hospitalized patients who survived a medical emergency team activation

Different approaches to investigate sleep apnea

Contact Info

Product

Resources

About