1051 A Novel Sleep Pilot Program to Streamline Care in Patients Undergoing Joint Replacement

Abstract Introduction The presence of sleep disordered breathing can have a significant impact on a patient’s perioperative risk. Diagnosis and treatment of obstructive sleep apnea (OSA) with positive air pressure (PAP) may help prevent post-operative complications. In this pilot program we hope to identify high risk patients early to help mitigate these risks. Methods We created a pilot program to help streamline patients undergoing joint replacement. In this program we identified high risk OSA patients, set them up with evaluation with our sleep medicine team and had them undergo standard of care sleep apnea testing. Once testing was completed patients received treatment if indicated. Results A total of 49 patients were evaluated 53% (26) of patients completed evaluation with the sleep medicine team. 8 out of the 49 patients completed their perioperative sleep apnea testing and had undergone their surgery. 9 out of the 49 patients did not complete their perioperative testing and had undergone surgery. Of the 9 that did not complete testing 4(44%) had readmission/visit to the emergency department (ED) post-surgery. 1 out of 8 (12%) who did complete testing had a readmission/visit to the ED. The average AHI of patients who completed testing was 14.67. Conclusion Early identification and intervention of patients with OSA may lead to less post operative readmissions/ED visits in patients undergoing joint replacement. Of note only 53% of patients completed evaluation with the sleep medicine team. This further identifies the importance of discussing with patients the risks that certain comorbidities may have when undergoing procedures. Although the sample size was small due to this being a pilot study, there was a 44% readmission/ED visit rate in patients who did not undergo testing or treatment for OSA. Further studies are needed to see if we can identify which patients with high suspicion for OSA are at greater risk for developing post operative complications to help streamline care and reduce hospital costs. Support (if any)