Unplanned admission after day surgery: A historical cohort study in patients with obstructive sleep apnea

Bryson, Gregory L.; Gómez, Carrasco; Jee, R.; Blackburn, Josée; Taljaard, Monica; Forster, Alan J.

doi:10.1007/s12630-012-9746-0

Cited by 24 publications

(15 citation statements)

References 28 publications

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“…A total of 1,547 unplanned readmissions were analyzed; the study concluded that OSA severity was not associated with an increased incidence of unplanned admissions. 22 Our study population did not experience any readmissions within 30 days after surgery.…”

Section: Discussionmentioning

confidence: 79%

A retrospective analysis on patients at high‐risk for obstructive sleep apnea undergoing ear, nose, and throat surgeries

Woodling

Fiorda-Diaz

Otto

et al. 2017

Laryngoscope Investig Oto

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BackgroundObstructive sleep apnea (OSA) may be related to episodes of oxygen de‐saturation, hypercapnia, cardiovascular dysfunction, cor‐pulmonale, and pulmonary hypertension. STOP‐BANG is an acronym for eight specific questions used to assess the likelihood of OSA. If the individual exhibits three or more of these indicators, he/she should be considered to be at high risk for OSA complications. Therefore, the decision of proceeding with inpatient versus outpatient ENT surgery still remains controversial. The primary objective of the study was to identify and correlate desaturation (SPO2 <90%) episodes and risk factors.MethodsWe conducted a single‐center retrospective study between October 1, 2011 and August 31, 2014 in order to identify postoperative complications during the first 24 hours that justify postoperative monitoring and hospital admission. A total of 292 subjects were included for data analysis. Patients were divided into two groups based on the number of OSA risk factors: group A with 3–4 risk factors (n = 166), and group B with ≥5 risk factors (n = 126). The following information was collected: demographics, ASA, preoperative STOP‐BANG score, length of surgery, intraoperative complications, opioid consumption, post anesthesia care unit (PACU) and overall length of stay, supplemental oxygen requirement, oxygen desaturation, and postoperative opioid consumption.ResultsNo statistically significant difference was found when comparing demographic variables between both groups. All STOP‐BANG variables showed statistical significance. PACU and inpatient variables were similar among both groups, with the exception of length of hospital stay (longer stay in group B when compared to group A [p = 0.003]). Desaturation differences between both groups during PACU were statistically significant (p = 0.008). A post‐hoc analysis showed a 0% incidence of overall desaturation in the group with three STOP‐BANG indicators.ConclusionsOur retrospective analysis concluded that patients diagnosed with three STOP‐BANG risk factors did not experience postoperative complications and hospital admission was not justified.Level of Evidence4

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Section: Discussionmentioning

confidence: 79%

A retrospective analysis on patients at high‐risk for obstructive sleep apnea undergoing ear, nose, and throat surgeries

Woodling

Fiorda-Diaz

Otto

et al. 2017

Laryngoscope Investig Oto

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“…42 A historical cohort study on 77,809 ambulatory surgical procedures did not identify any clinically significant increased rate of unplanned admission related to a prior diagnosis of 674 OSA patients. 43 The lack of increased postoperative complications in these studies may have been due to careful selection of OSA patients for ambulatory surgery, use of CPAP, and minimal opioids.…”

Section: Patient Selection For Ambulatory Surgerymentioning

confidence: 99%

Ambulatory anesthesia for patients with sleep apnea

Raveendran¹,

Chung²

2015

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The prevalence of obstructive sleep apnea (OSA) is increasing, and a significant number of patients with OSA presenting for ambulatory surgeries are undiagnosed. It is well known that patients with OSA have increased postoperative complications. The suitability of ambulatory surgery in patients with OSA remains controversial, and the evidence regarding the safety of OSA patients for ambulatory surgery is inadequate. Anesthesiologists play an important role in identifying, evaluating, and optimizing the OSA patient. Preoperative screening and careful selection of patients for ambulatory surgery is the key step during the perioperative management of OSA patients. With proper screening and clinical algorithm-based management, patients with OSA may be treated safely as ambulatory surgical patients.

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“…Studies published to date suggest that unanticipated admission is not increased in patients with known or suspected OSA [88][89][90][91][92]. Transient hypoxemia has been described in some patients postoperatively in two observational cohort studies, though the lack of control groups, as well as the lack of changes in other outcomes, makes the relevance of these findings debatable [90,91].…”

Section: Ambulatory Surgerymentioning

confidence: 99%

“…In the largest systematic review to date to examine this topic, 11 studies found higher resource utilization in OSA patients versus eight studies that did not [80••]. As noted earlier, rates of unplanned admissions following ambulatory surgery have not been shown to be higher for patients with OSA [88][89][90][91][92]. Critical care resource requirements may be more significant in surgical patients with OSA, though few studies have measured this outcome [25,109,[123][124][125].…”

Section: Resource Utilizationmentioning

confidence: 99%

Perioperative Complications in Obstructive Sleep Apnea Patients

Auckley

2016

Curr Sleep Medicine Rep

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Obstructive sleep apnea (OSA) is growing in prevalence though it still remains significantly underdiagnosed. Preoperative screening for OSA is taking place in many institutions, with a substantial number of patients being identified as having a high probability for OSA just prior to undergoing surgery. Emerging data increasingly demonstrates that patients with a high probability of having OSA as well as those with a known diagnosis of OSA may be at increased risk for developing complications in the perioperative setting. Postoperative cardiac and pulmonary adverse events appear to occur more frequently in these patients though the impact OSA has on postoperative mortality is controversial. In addition, determining which patients are at greatest risk remains an area of uncertainty. This chapter will review the current state of the knowledge regarding OSA as a risk factor for perioperative complications.

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Unplanned admission after day surgery: A historical cohort study in patients with obstructive sleep apnea

Cited by 24 publications

References 28 publications

A retrospective analysis on patients at high‐risk for obstructive sleep apnea undergoing ear, nose, and throat surgeries

A retrospective analysis on patients at high‐risk for obstructive sleep apnea undergoing ear, nose, and throat surgeries

Ambulatory anesthesia for patients with sleep apnea

Perioperative Complications in Obstructive Sleep Apnea Patients

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