Development and validation of a Score for Preoperative Prediction of Obstructive Sleep Apnea (SPOSA) and its perioperative outcomes

BMC Anesthesiology

Research Article

Scott Devine¹  Noomi Mueller²  Fanny P. Timm²  Khushi Chhangani²  Stephanie D. Grabitz²  Christina H. Shin³  Matthias Eikermann⁴  Karim Ladha⁵  Tobias Kurth⁶ 

[1] Center for Observational and Real-World Effectiveness US Outcomes Research, Merck & Co., Inc, Boston, Massachusetts, USA;Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, USA;Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, USA;Harvard Medical School, Boston, Massachusetts, USA;Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, USA;Harvard Medical School, Boston, Massachusetts, USA;Universitaet Duisburg-Essen, Essen, Germany;Department of Anesthesia, Toronto General Hospital and University of Toronto, Toronto, Canada;Harvard Medical School, Boston, Massachusetts, USA;Institute of Public Health, Charité Universitätsmedizin Berlin, Berlin, Germany;Brigham and Women’s Hospital, Boston, Massachusetts, USA;

关键词: Perioperative obstructive sleep apnea;    Prediction;    Outcomes;    Postoperative respiratory complications;    In-hospital mortality;   

DOI  :  10.1186/s12871-017-0361-z

 received in 2016-12-23, accepted in 2017-05-17,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundPostoperative respiratory complications (PRCs) are associated with significant morbidity, mortality, and hospital costs. Obstructive sleep apnea (OSA), often undiagnosed in the surgical population, may be a contributing factor. Thus, we aimed to develop and validate a score for preoperative prediction of OSA (SPOSA) based on data available in electronic medical records preoperatively.MethodsOSA was defined as the occurrence of an OSA diagnostic code preceded by a polysomnography procedure. A priori defined variables were analyzed by multivariable logistic regression analysis to develop our score. Score validity was assessed by investigating the score’s ability to predict non-invasive ventilation. We then assessed the effect of high OSA risk, as defined by SPOSA, on PRCs within seven postoperative days and in-hospital mortality.ResultsA total of 108,781 surgical patients at Partners HealthCare hospitals (2007–2014) were studied. Predictors of OSA included BMI >25 kg*m−2 and comorbidities, including pulmonary hypertension, hypertension, and diabetes. The score yielded an area under the curve of 0.82. Non-invasive ventilation was significantly associated with high OSA risk (OR 1.44, 95% CI 1.22–1.69). Using a dichotomized endpoint, 26,968 (24.8%) patients were identified as high risk for OSA and 7.9% of these patients experienced PRCs. OSA risk was significantly associated with PRCs (OR 1.30, 95% CI 1.19–1.43).ConclusionSPOSA identifies patients at high risk for OSA using electronic medical record-derived data. High risk of OSA is associated with the occurrence of PRCs.

【 授权许可】

CC BY   
© The Author(s). 2017