Hospital outcomes in non-surgical patients identified at risk for OSA.
Sikandar H Khan, Shalini Manchanda, Ninotchka L Sigua and 4 others
PMID 31879037WHAT IT FOUND
Hospitalized non-surgical patients screened as high-risk for sleep apnea did not have more respiratory failure than low-risk patients.
They stayed slightly longer in the hospital but had lower in-hospital mortality. Low-risk patients unexpectedly required more invasive mechanical ventilation.
Key findings
01There was no significant difference in the primary outcome of respiratory failure between patients identified as high-risk versus low-risk for obstructive sleep apnea.
02Patients in the high-risk group had significantly lower in-hospital mortality compared to the low-risk group.
03Contrary to expectations, patients in the low-risk group received more orders for invasive mechanical ventilation than those in the high-risk group.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was retrospective, so it is unclear whether clinicians were aware of the Berlin Questionnaire results or how this knowledge influenced patient management. The Berlin Questionnaire was validated in sleep clinic and surgical populations, so its accuracy in identifying risk among non-surgical medical patients may be limited. Patients with a known diagnosis of obstructive sleep apnea were excluded, meaning the study does not reflect outcomes for the highest-risk group. Data on opioid use was limited to medication orders rather than actual administration, which may underestimate the impact of sedatives on respiratory outcomes. The study could not determine if high-risk patients received closer monitoring or different care pathways that might explain the lower mortality.
Declared interests
The paper does not report any conflicts of interest or specific funding sources beyond NIH extramural support.
The easy way to misread this
Do not interpret the lower mortality in high-risk patients as evidence that sleep apnea is protective. The authors suggest this finding may be due to increased clinical attention and monitoring triggered by the screening process, not the condition itself.