title: Perioperative management of obstructive sleep apnea: a survey of Veterans Affairs health care providers.
abstract: OBJECTIVE
  (1) To determine the presence of Veterans Affairs (VA) institutional guidelines for the perioperative management of obstructive sleep apnea (OSA); (2) to examine current use of preoperative screening tools for OSA in the VA; and (3) to understand current VA practice patterns regarding postoperative disposition of patients with OSA.
  
  
  METHODS
  Survey study.
  
  
  METHODS
  Veterans Affairs hospitals with surgical services; sample size 102 facilities.
  
  
  METHODS
  Veterans Affairs health care providers.
  
  
  METHODS
  The authors surveyed health care providers at VA hospitals using a survey tool developed by the authors.
  
  
  RESULTS
  The response rate was 80%. A variety of preoperative screening tools for OSA were used by respondents, most commonly American Society of Anesthesiologists guidelines (53%). A policy for postoperative disposition of known and presumed OSA was present in 26% and 19% of responses, respectively. Of those respondents reporting a formal postoperative care policy, 48% and 30% admitted patients to a monitored ward bed and surgical intensive care unit, respectively. Of the 74% of respondents unaware of an institutional policy, Anesthesia and Surgery worked together to dictate postoperative disposition of patients with known OSA 73% of the time. The degree of OSA was ranked as the most important factor (58%) influencing postoperative disposition. Ten percent of respondents reported a major perioperative complication attributable to OSA in the past year.
  
  
  CONCLUSIONS
  This survey study elucidates the heterogeneity of preoperative screening for and postoperative care of veterans with OSA. Future investigators may use these data to formalize institutional policies with regard to patients with OSA, with potentially significant impacts on patient care and usage of financial resources.
authors: University of Cincinnati Department of Otolaryngology-Head and Neck Surgery, Cincinnati, Ohio, USA. reenadhanda@aol.com
authors: Reena
authors: R
authors: Dhanda Patil
authors: Yash J
authors: YJ
authors: Patil
mesh_terms: D019468:Disease Management; D019983:Guideline Adherence; D019538:Health Care Surveys / Q000379:methods*; D006282:Health Personnel / Q000592:standards*; D006787:Hospitals, Veterans; D006801:Humans; D019990:Perioperative Care / Q000379:methods*; D010818:Practice Patterns, Physicians' / Q000592:standards; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000601:surgery; D014481:United States; D014728:Veterans