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

STUDY OBJECTIVE: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 (PSM) was used to match patient physical characteristics, comorbidities, length of stay, and inpatient CPAP usage. META and ICU admissions during the surgical encounter, 30-day hospital readmissions, and 30-day ED visits were evaluated. RESULTS:1,509 of 2,926 AF patients completed the DOISNORE50 questionnaire and were enrolled in the OSA safety protocol. Following propensity score matching, there was a reduced adjusted odds of META in the screened group of 0.69 (95% CI: 0.48-0.98, p<0.001) in comparison to the non-screened group. The adjusted odds of intensive care unit (ICU) admissions and ED visits within 30-days of discharge were statistically lower for the screened group compared to non-screened group. CONCLUSIONS:Among perioperative AF patients, evidence supports DOISNORE50 screening and implementation of an OSA safety protocol for reduction of META. This study identified a decreased odd of META, ICU admissions, and ED visits among screened group. The High-Risk and Known OSA group showed reduced odds of META following the implementation of an OSA safety protocol.