BACKGROUND: Obstructive sleep apnea (OSA) has been identified as an important risk factor in perioperative orthopaedic surgery outcomes despite limited evidence. Screening systems are being instituted in increasing frequency to prevent morbidity and mortality. Our objective was to determine if patients with OSA have a higher likelihood of postoperative in-hospital complications, length of stay, or increased costs after shoulder arthroplasty. METHODS: We utilized the Nationwide Inpatient Sample (NIS) to analyze 22988 patients undergoing TSA or hemiarthroplasty. Of these patients, 1983 (5.9%) were diagnosed with OSA. Multivariate analysis with logistic regression modeling was used to compare patients with and without OSA for various outcomes. RESULTS: Patients with obstructive sleep apnea had overall similar in-hospital mortality and complications including PE compared with those without OSA. OSA was not associated with increased postoperative charges ($39,741 in patients with OSA vs. $39,334 in those without OSA) and resulted in a shorter length of stay (mean, 2.61 vs. 2.91 days; P < .0001). CONCLUSION: This study does not support OSA as a significant risk factor for in-hospital morbidity and mortality following shoulder arthroplasty. Our results suggest that a diagnosis of OSA does not increase perioperative morbidity and mortality including perioperative complications. Given the results of this study, further research is warranted to attempt to keep patient screening costs down while optimizing outcomes.
BACKGROUND:Obstructive sleep apnea (OSA) has been identified as an important risk factor in perioperative orthopaedic surgery outcomes despite limited evidence. Screening systems are being instituted in increasing frequency to prevent morbidity and mortality. Our objective was to determine if patients with OSA have a higher likelihood of postoperative in-hospital complications, length of stay, or increased costs after shoulder arthroplasty. METHODS: We utilized the Nationwide Inpatient Sample (NIS) to analyze 22988 patients undergoing TSA or hemiarthroplasty. Of these patients, 1983 (5.9%) were diagnosed with OSA. Multivariate analysis with logistic regression modeling was used to compare patients with and without OSA for various outcomes. RESULTS:Patients with obstructive sleep apnea had overall similar in-hospital mortality and complications including PE compared with those without OSA. OSA was not associated with increased postoperative charges ($39,741 in patients with OSA vs. $39,334 in those without OSA) and resulted in a shorter length of stay (mean, 2.61 vs. 2.91 days; P < .0001). CONCLUSION: This study does not support OSA as a significant risk factor for in-hospital morbidity and mortality following shoulder arthroplasty. Our results suggest that a diagnosis of OSA does not increase perioperative morbidity and mortality including perioperative complications. Given the results of this study, further research is warranted to attempt to keep patient screening costs down while optimizing outcomes.
Authors: Samuel Rosas; Karim G Sabeh; Leonard T Buller; Tsun Yee Law; Steven P Kalandiak; Jonathan C Levy Journal: J Shoulder Elbow Surg Date: 2017-01-27 Impact factor: 3.019
Authors: Hind A Beydoun; May A Beydoun; Hong Cheng; Anjum Khan; Shaker M Eid; Carolina Alvarez-Garriga; Colin Anderson-Smits; Alan B Zonderman; Danica Marinac-Dabic Journal: J Craniomaxillofac Surg Date: 2018-05-24 Impact factor: 2.078
Authors: Matthew T V Chan; Chew Yin Wang; Edwin Seet; Stanley Tam; Hou Yee Lai; Eleanor F F Chew; William K K Wu; Benny C P Cheng; Carmen K M Lam; Timothy G Short; David S C Hui; Frances Chung Journal: JAMA Date: 2019-05-14 Impact factor: 56.272
Authors: Christopher A Wang; Joseph R Palmer; Michael O Madden; Wayne Cohen-Levy; Rushabh M Vakharia; Martin W Roche Journal: J Orthop Date: 2019-05-01
Authors: Frances Chung; Stavros G Memtsoudis; Satya Krishna Ramachandran; Mahesh Nagappa; Mathias Opperer; Crispiana Cozowicz; Sara Patrawala; David Lam; Anjana Kumar; Girish P Joshi; John Fleetham; Najib Ayas; Nancy Collop; Anthony G Doufas; Matthias Eikermann; Marina Englesakis; Bhargavi Gali; Peter Gay; Adrian V Hernandez; Roop Kaw; Eric J Kezirian; Atul Malhotra; Babak Mokhlesi; Sairam Parthasarathy; Tracey Stierer; Frank Wappler; David R Hillman; Dennis Auckley Journal: Anesth Analg Date: 2016-08 Impact factor: 5.108