title: Obstructive Sleep Apnea Is Not Associated with Higher Health Care Use after Colonoscopy under Conscious Sedation.
abstract: BACKGROUND
  The use of sedation allows medical procedures to be performed outside the operating room while ensuring patient comfort and a controlled environment to increase the yield of the procedure. There is concern about a higher risk of adverse events with use of sedation in patients with obstructive sleep apnea.
  
  
  OBJECTIVE
  We aimed to determine if the presence of obstructive sleep apnea increased the risk of hospitalization and/or health care use after patients received moderate conscious sedation for an elective, ambulatory colonoscopy.
  
  
  METHODS
  We conducted a retrospective case-control database and chart review study. We compared hospital admissions, intensive care unit (ICU) admissions, and emergency room visits at 24 hours, 7 days, and 30 days in patients with obstructive sleep apnea (n = 3,860) and without obstructive sleep apnea (n = 2,374) who had undergone an elective, ambulatory colonoscopy with sedation.
  
  
  RESULTS
  We found no significant differences in hospital admissions, ICU admissions, or emergency room visits between the two groups at any time point within the 30 days following the procedures. In a sensitivity analysis in which we compared 827 individuals with polysomnographically confirmed sleep apnea with control subjects, there was still no difference in hospital admissions, ICU admissions, or emergency room visits in the 30 days after receiving sedation for the procedure. Outcomes were not different in individuals with various severities of obstructive sleep apnea.
  
  
  CONCLUSIONS
  The presence of obstructive sleep apnea was not associated with increased early hospital admissions, ICU admissions, or emergency room visits after colonoscopy with sedation.
authors.affiliation: 1 Section of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine.|2 Medical Care Line, Section of Pulmonary, Critical Care and Sleep Medicine, Michael E. DeBakey VA Medical Center, Houston, Texas.
authors.forename: Lakshmi
authors.initials: L
authors.lastname: Mudambi
authors.affiliation: 3 VA Vision Center of Excellence, Department of Defense, Bethesda, Maryland.
authors.forename: Andrew
authors.identifier: http://orcid.org/0000-0002-7893-2946
authors.initials: A
authors.lastname: Spiegelman
authors.affiliation: 1 Section of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine.
authors.forename: Duncan
authors.initials: D
authors.lastname: Geron
authors.affiliation: 1 Section of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine.|2 Medical Care Line, Section of Pulmonary, Critical Care and Sleep Medicine, Michael E. DeBakey VA Medical Center, Houston, Texas.
authors.forename: Max
authors.initials: M
authors.lastname: Hirshkowitz
authors.affiliation: 4 Section of Pulmonary and Critical Care, Department of Medicine, University of Chicago, Chicago, Illinois; and.
authors.forename: Babak
authors.initials: B
authors.lastname: Mokhlesi
authors.affiliation: 5 Section of Gastrointestinal Medicine, Department of Medicine, and.|6 Medical Care Line, Section of Gastrointestinal Medicine, Baylor College of Medicine, Houston, Texas.
authors.forename: Yasser
authors.initials: Y
authors.lastname: Shaib
authors.affiliation: 1 Section of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine.|2 Medical Care Line, Section of Pulmonary, Critical Care and Sleep Medicine, Michael E. DeBakey VA Medical Center, Houston, Texas.
authors.forename: Suryakanta
authors.initials: S
authors.lastname: Velamuri
authors.affiliation: 1 Section of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine.|2 Medical Care Line, Section of Pulmonary, Critical Care and Sleep Medicine, Michael E. DeBakey VA Medical Center, Houston, Texas.
authors.forename: Charlie O
authors.initials: CO
authors.lastname: Lan
authors.affiliation: 1 Section of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine.|2 Medical Care Line, Section of Pulmonary, Critical Care and Sleep Medicine, Michael E. DeBakey VA Medical Center, Houston, Texas.
authors.forename: Amir
authors.initials: A
authors.lastname: Sharafkhaneh
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D003113:Colonoscopy / Q000706:statistics & numerical data*; D015897:Comorbidity; D016292:Procedural Sedation / Q000009:adverse effects; D016208:Databases, Factual; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017286:Polysomnography; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology*; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
keywords: endoscopy; mortality; procedure outcome