012 Incidence and Characteristics of Men at High Risk for Sleep Apnea in a High Volume Andrology Clinic

Abstract Introduction The STOP-Bang Questionnaire is a validated instrument to assess an individual’s risk for obstructive sleep apnea (OSA). The prevalence of OSA is estimated at 20% in the US with only 20% of those individuals properly diagnosed. Dentists are being asked to screen and refer patients at high risk for OSA for definitive diagnosis and treatment. The aim of this study was to determine whether patients in a dental school student clinic who were identified as high-risk for OSA, were referred for evaluation of OSA. Methods All new patients over the age of 18 admitted to The Ohio State University - College of Dentistry complete an “Adult Medical History Form”. Included in this study were 21,312 patients admitted between July 2017 and March 2020. Data were extracted from the history form to determine the STOP-Bang Score for all patients: age, sex, BMI, self-reported snoring-, stopped breathing/choking/gasping while sleeping-, high blood pressure-, neck size over 17” (males) or 16” (females)-, and tiredness. Each positive response is a point, for a maximum of 8 points possible. Additionally, any previous diagnosis of sleep apnea, and the patient’s history of referrals were extracted from the health record. According to clinic policy, if the patient did not have a previous diagnosis for OSA noted in the health history, and scored 5 or more on the STOP-Bang Questionnaire, they should receive a referral for an evaluation for OSA. Notes and referral forms were reviewed to determine if the appropriate referrals occurred for patients at high risk without a previous diagnosis. Results Of the 21,312 patients screened; 1098 (5.2%) screened high-risk for OSA, of which 398 had no previous diagnosis of OSA. Of these 398 patients, none (0%) had referrals for further evaluation for OSA. Conclusion The rate of appropriate referrals from a student dental clinic with an electronic health record was unacceptably low. Continued education and changes to the electronic health record are needed to ensure those at high-risk for OSA are appropriately referred and managed. Support (if any):

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480 Cardiovascular and metabolic risk in patients with suspected comorbid insomnia and obstructive sleep apnea (COMISA)

SLEEP ◽

10.1093/sleep/zsab072.479 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A189-A190

Author(s):

Miguel Meira e Cruz ◽

Luana Seixas ◽

Augusto Santos ◽

João Garrido ◽

Yuri Lopes ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

High Risk ◽

Arterial Hypertension ◽

Sleep Time ◽

Comorbid Condition ◽

Therapeutic Success ◽

Comorbid Insomnia ◽

Systemic Arterial Hypertension ◽

Obstructive Sleep

Abstract Introduction Only few studies looked for a possible association of cardiovascular disorders (CVD), in comorbid insomnia with obstructive sleep apnea (COMISA) even though this is a relevant topic in order to prevent one of the major causes of morbimortality. The present study aimed to investigate the association of insomnia symptoms in patients at risk for obstructive sleep apnea in terms of prevalence and clinical interactions and to evaluate the risk of CVD in patients with a risk for COMISA. Methods This is a cross-sectional study. All medical records with data such as age, sex, height, weight and BMI, time to sleep, time to wake up, total sleep time, the Epworth Sleepiness Scale (ESS), STOP-BANG Questionnaires were studied. Insomnia and comorbidities were also investigated, and the patientsanswered yes or no to systemic arterial hypertension, diabetes, CVD. Results 685 patients were enrolled on the present study. We observed that the mild, moderate, and high risk for COMISA presented progressively increasing levels for the frequency of hypertension, diabetes, and CVD. A binary logistic regression was performed to assess whether risk for COMISA could be a predictor for CVD, and it was found that the model containing risk for COMISA was statistically significant: [x2(1)=5.273;p<0.021, R2 Negelkerke=0.014]. Risk for COMISA presented itself as a significant predictor for CVD (OR=1.672; 95% CI=1.079–2.592). Conclusion There was an increased frequency of associated comorbidities such as CVD, systemic arterial hypertension, and diabetes, according to the mild, moderate, or high risk. These findings highlight the need for a cardiometabolic evaluation in patients with this comorbid condition which may impact prognosis and therapeutic success. Support (if any):

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Perioperative myocardial injury risk after elective knee and hip arthroplasty in patients with a high risk of obstructive sleep apnea

Sleep And Breathing ◽

10.1007/s11325-020-02068-3 ◽

2020 ◽

Author(s):

Steven Lee ◽

AJ Hirsch Allen ◽

Erin Morley ◽

Petrus Swart ◽

William Henderson ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

High Risk ◽

Hip Arthroplasty ◽

Injury Risk ◽

Myocardial Injury ◽

Obstructive Sleep ◽

Knee And Hip Arthroplasty

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Improved Outcomes Amongst High Risk Lung Transplant Patients at High Volume Centers: A Case for Regionalization in the US

The Journal of Heart and Lung Transplantation ◽

10.1016/j.healun.2015.01.673 ◽

2015 ◽

Vol 34 (4) ◽

pp. S243

Author(s):

J.C. Grimm ◽

J. Magruder ◽

A. Kilic ◽

V. Valero ◽

S.P. Dungan ◽

...

Keyword(s):

High Risk ◽

Lung Transplant ◽

High Volume ◽

Transplant Patients ◽

Improved Outcomes ◽

The Us

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High risk of obstructive sleep apnea in total joint replacement patients

Journal of Pain ◽

10.1016/j.jpain.2011.02.109 ◽

2011 ◽

Vol 12 (4) ◽

pp. P27

Author(s):

R. Hamill-Ruth ◽

A. Kipp ◽

R. Rome ◽

E. Gochenour

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

High Risk ◽

Joint Replacement ◽

Total Joint Replacement ◽

Obstructive Sleep

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A retrospective analysis on patients at high-risk for obstructive sleep apnea undergoing ear, nose, and throat surgeries

Laryngoscope Investigative Otolaryngology ◽

10.1002/lio2.131 ◽

2017 ◽

Vol 3 (1) ◽

pp. 16-21

Author(s):

Karina Woodling ◽

Juan Fiorda-Diaz ◽

Bradley A. Otto ◽

Christie A. Barnes ◽

Alberto A. Uribe ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

High Risk ◽

Retrospective Analysis ◽

Obstructive Sleep ◽

Nose And Throat

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Cost-effectiveness analysis of SARS-CoV-2 infection prevention strategies including pre-endoscopic virus testing and use of high risk personal protective equipment

Endoscopy ◽

10.1055/a-1294-0427 ◽

2020 ◽

Author(s):

Alanna Ebigbo ◽

Christoph Römmele ◽

Christina Bartenschlager ◽

Selin Temizel ◽

Elisabeth Kling ◽

...

Keyword(s):

Cost Effectiveness ◽

High Risk ◽

Personal Protective Equipment ◽

Infection Prevention ◽

High Volume ◽

Protective Equipment ◽

Prevalence Rates ◽

Prevention Strategies ◽

Universal Testing ◽

Asymptomatic Patients

Abstract Background Infection prevention strategies to protect healthcare workers in endoscopy units during the post-peak phase of the COVID-19 pandemic are currently under intense discussion. In this paper, the cost-effectiveness of routine pre-endoscopy testing and high risk personal protective equipment (PPE) is addressed. Method A model based on theoretical assumptions of 10 000 asymptomatic patients presenting to a high volume center was created. Incremental cost-effectiveness ratios (ICERs) and absolute costs per endoscopy were calculated using a Monte Carlo simulation. Results ICER values for universal testing decreased with increasing prevalence rates. For higher prevalence rates (≥ 1 %), ICER values were lowest for routine pre-endoscopy testing coupled with use of high risk PPE, while cost per endoscopy was lowest for routine use of high risk PPE without universal testing. Conclusion In general, routine pre-endoscopy testing combined with high risk PPE becomes more cost-effective with rising prevalence rates of COVID-19.

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