Preoperative sleep apnea screening protocol reduces medical emergency team activation in patients with atrial fibrillation.

Autor:	Saha AK; Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina., Sheehan KN; Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina., Xiang KR; Department of Internal Medicine, Section of Pulmonary and Critical Care Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina., Rackley J; Department of Internal Medicine, Section of Cardiology, Penn State College of Medicine, Hershey, Pennsylvania., Hicklin H; Department of Internal Medicine, Section of Cardiology, Wake Forest School of Medicine, Winston-Salem, North Carolina., Koch AL; Department of Internal Medicine, Section on Pulmonary and Critical Care Medicine, University of Miami, Miami, Florida., Bhave PD; Department of Internal Medicine, Section of Cardiology, Wake Forest School of Medicine, Winston-Salem, North Carolina., Forest DJ; Department of Anesthesiology, Novant and Piedmont Triad Anesthesia, Winston-Salem, North Carolina., Kirsch DB; Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina., Ghatak R; Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina., Haponik EF; Department of Internal Medicine, Section of Pulmonary and Critical Care Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina., Peters SP; Department of Internal Medicine, Section of Pulmonary and Critical Care Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina., Namen AM; Department of Internal Medicine, Section of Pulmonary and Critical Care Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.
Jazyk:	angličtina
Zdroj:	Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine [J Clin Sleep Med] 2024 May 01; Vol. 20 (5), pp. 783-792.
DOI:	10.5664/jcsm.11002
Abstrakt:	Study Objectives: The association of in-hospital medical emergency team activation (META) among patients with atrial fibrillation (AF) at risk for obstructive sleep apnea (OSA) is unclear. This study evaluates the performance of the DOISNORE50 sleep questionnaire as an OSA screener for patients with AF and determines the prevalence of META among perioperative patients with underlying AF who have a diagnosis or are at risk for OSA. Methods: A prospective perioperative cohort of 2,926 patients with the diagnosis of AF was assessed for DOISNORE50 questionnaire screening. Propensity-score matching was used to match patients' physical characteristics, comorbidities, length of stay, and inpatient continuous positive airway pressure device usage. META and intensive care unit admissions during the surgical encounter, 30-day hospital readmissions, and 30-day emergency department visits were evaluated. Results: A total of 1,509 out of 2,926 AF patients completed the DOISNORE50 questionnaire and were enrolled in the OSA safety protocol. Following propensity-score matching, there were reduced adjusted odds of META in the screened group of 0.69 (95% confidence interval: 0.48-0.98, P < .001) in comparison to the unscreened group. The adjusted odds of intensive care unit admissions and emergency department visits within 30 days of discharge were statistically lower for the screened group compared with the unscreened group. Conclusions: Among perioperative AF patients, evidence supports DOISNORE50 screening and implementation of an OSA safety protocol for reduction of META. This study identified decreased odds of META, intensive care unit admissions, and emergency department visits among the screened group. The high-risk and known OSA group showed reduced odds of META following the implementation of an OSA safety protocol. Citation: Saha AK, Sheehan KN, Xiang KR, et al. Preoperative sleep apnea screening protocol reduces medical emergency team activation in patients with atrial fibrillation. J Clin Sleep Med . 2024;20(5):783-792. (© 2024 American Academy of Sleep Medicine.)
Databáze:	MEDLINE
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