Prevalence of obstructive sleep apnea in surgical patients presenting to a tertiary care teaching hospital in India: A preliminary study

Abstract

Background:Obstructive sleep apnea (OSA) is often not diagnosed in patients presenting for surgical procedures thereby increasing the incidence of adverse perioperative course. Early diagnosis of this disease is important in modifying anesthetic management as well as utilizing specific means which may decrease the complications and improve the patient outcome.Methods:Patients greater than eighteen years of age, ASA I-III scheduled for elective surgical procedures under anesthesia were randomly selected. Their demographic data, diagnosis and nature of surgery were noted in a semi-structured performa. They were then screened for the presence of OSA with the help of a STOP BANG questionnaire.Results:This study included two hundred four patients randomly selected. Slight female predominance was seen in this sample (55.4%). Mean age of the subjects was 42.7 years (SD=15.08). 24.5% subjects were at high risk for OSA (STOP-BANG>3) with a male predominance (72% versus 37% in low risk group; X2=18.62; P<0.001). High risk OSA subjects had higher prevalence of cardiovascular risk factors (57% vs. 11.7% in low risk group; X2=33.35; P<0.001). Similarly, this group had a higher prevalence of asthma and chronic obstructive pulmonary disease (COPD) (14% versus 3.8% in low risk group; X2=6.54; P=0.03). Prevalence of diabetes mellitus (22%) and hypothyroidism (6%) was also higher in this group (5.2% and 1.9% in low risk group respectively; X2=15.42; P<0.001).Conclusion:High degree of suspicion and knowledge of association of OSA and medical diseases may help in detection of such cases and decrease the rate of perioperative complications thus improving patients safety.

Morbidly obese patient with obstructive sleep apnoea for major spine surgery: An anaesthetic challenge

“…The authors concluded that a high degree of suspicion and knowledge of association of OSA and medical diseases may help in detection of such cases and decrease the rate of perioperative complications thus improving patients' safety. [ 9 ]…”

Undiagnosed Obstructive Sleep Apnea and Postoperative Outcomes: A Prospective Observational Study

“…Given a prevalence of 2-9.4% of OSA in our population [2,19] , only 8/8,824 (0.09%) patients had diagnosed or treated OSA during the screening period in this cohort, suggesting gross underrecognition of OSA. While the actual [5,6,20,21] and points to the magnitude of this problem. Thus, the first recognition of OSA during preoperative evaluation is not an infrequent event.…”

An update on the various practical applications of the STOP-Bang questionnaire in anesthesia, surgery, and perioperative medicine

“…Several studies have shown that high-risk OSA (STOP-Bang ≥3) patients identified by the STOP-Bang questionnaire have higher BMI [18,23], higher ASA physical status [16,18,23], and increased comorbidities [16,18,23,37]. High-risk OSA (STOP-Bang ≥3) patients were older, had higher incidence of ischemic heart disease, heart failure, hypertension, dyslipidemia, arrhythmia, chronic obstructive pulmonary disease, hypothyroidism and diabetes mellitus [16,18,23,37].…”

“…High-risk OSA (STOP-Bang ≥3) patients were older, had higher incidence of ischemic heart disease, heart failure, hypertension, dyslipidemia, arrhythmia, chronic obstructive pulmonary disease, hypothyroidism and diabetes mellitus [16,18,23,37]. Screening with STOP-Bang and the knowledge of the association of OSA and comorbid diseases may decrease the rate of perioperative complications thus improving patients’ safety.…”