0521 Perioperative Positive Airway Pressure Compliance in Obstructive Sleep Apnea Patients

Abstract

Obstructive sleep apnea (OSA) increases risk for perioperative complications, so screening for OSA is recommended preoperatively. Preoperative patients with OSA and prescribed positive airway pressure (PAP) therapy are advised to use PAP after surgery. Postoperative circumstances may alter the PAP experience. Patterns of postoperative PAP use are not fully defined. Our aim was to use PAP download data to characterize perioperative PAP adherence and apnea-hypopnea indices (AHI) in a cohort of OSA patients. Single-center, retrospective review of surgical patients with OSA on PAP therapy in whom we had pre- and postoperative PAP download information. Surgeries included were: knee, hip, and shoulder arthroplasty; cholecystectomy; partial or complete colectomy; hysterectomy; and prostatectomy after 10/1/2015. Seventy-six patients (45% female) with mean age 67 ± 12 years and mean baseline AHI 36 ± 29 events/hour were identified. Only 2 patients (3%) did not use their PAP immediately after surgery. For the remaining 74 patients, the mean use of PAP in the 30 days preoperatively was 408 ± 99 minutes per night versus 413 ± 125 minutes per night during the 7 days postoperatively (p = 0.6). PAP usage duration was greatest on the first postoperative night. The mean AHI in the 30 days preoperatively was 3.4 ± 5.2 events/hour versus 4.8 ± 7.4 events/hour over the 7 days postoperatively (p = 0.004). There were no significant differences in the preoperative versus postoperative PAP adherence or AHI values in those undergoing inpatient (62 patients; 84%) versus outpatient surgery. Compared to the preoperative period, nightly PAP use did not decline in the 7 days postoperatively in our cohort, although the AHI increased slightly but in a statistically significant manner. No significant changes in PAP usage or AHI were found when comparing inpatient versus outpatient surgeries. Support (If Any):