title: Safety of outpatient surgery for obstructive sleep apnea.
abstract: OBJECTIVE
  Determine the safety experience of adult obstructive sleep apnea patients undergoing airway surgery.
  
  
  METHODS
  A retrospective cohort study.
  
  
  METHODS
  The experience of members of a large Medicaid managed care organization between January 10, 2009, and June 30, 2011.
  
  
  METHODS
  Four hundred fifty-two adult Medicaid obstructive sleep apnea (OSA) patients (404 ambulatory, 48 inpatient) receiving head and neck airway surgery form the basis of this report. Four safety indicators were reported from administrative data for 30 days: emergency room visit, inpatient admission, observation day, and 3 or more primary care physician visits. The occurrence of myocardial infarction, deep venous thrombosis, stroke, pulmonary embolism, tracheostomy, or transfusion was noted.
  
  
  RESULTS
  Ninety-four percent of the nasal, 86% of the palatal, and 79% of the nasal/palatal surgeries (89% overall) were ambulatory. The observed catastrophic complication rate among ambulatory patients was zero (95% confidence interval, 0.0%-1.1%). Emergency room visits for pain-related diagnoses were the most common adverse outcome (51%). Administrative data sets can be used to provide insight into practice safety questions.
  
  
  CONCLUSIONS
  Contrary to guidelines, most OSA patients underwent ambulatory head and neck airway surgery. The observed catastrophic complication rate was zero. Administrative data sets can be used to provide insight into practice safety questions. Further study is warranted of ambulatory surgery management of adult sleep apnea patients.
authors: Division of Otolaryngology, Department of Surgery, Otolaryngology/Head & Neck Surgery, University of Toledo-Health Science Campus, Toledo, Ohio 43614, USA. reginald.baugh@utoledo.edu
authors: Reginald
authors: R
authors: Baugh
authors: Bonnie
authors: B
authors: Burke
authors: Brian
authors: B
authors: Fink
authors: Richard
authors: R
authors: Garcia
authors: Alan
authors: A
authors: Kominsky
authors: Kathleen
authors: K
authors: Yaremchuk
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000706:statistics & numerical data; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009820:Ohio / Q000453:epidemiology; D061214:Patient Safety; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000601:surgery*