title: Hospitalized Patients at High Risk for Obstructive Sleep Apnea Have More Rapid Response System Events and Intervention Is Associated with Reduced Events.
abstract: Rapid response system (RRS) is a safety tool designed for early detection and intervention of a deteriorating patient on the general floor in the hospital. Obstructive sleep apnea (OSA) has been associated with significant cardiovascular complications. We hypothesized that patients with high-risk of OSA have higher rate of RRS events and intervention with positive airway pressure therapy in these patients can mitigate the RRS events.
  
  
  
  As part of a clinical pathway, during a 15 month period, patients with BMI ≥ 30 kg/m2 in select medical services were screened with a validated sleep questionnaire. Patients were characterized as high or low risk based on the screening questionnaire. RRS rates were compared between the groups. Subsequently the impact of PAP therapy on RRS events was evaluated.
  
  
  
  Out of the 2,590 patients screened, 1,973 (76%) were identified as high-risk. RRS rates calculated per 1,000 admissions, were 43.60 in the High-Risk OSA group versus 25.91 in the Low-Risk OSA Group. The PAP therapy compliant group had significantly reduced RRS event rates compared to non-compliant group and group with no PAP therapy (16.99 vs. 53.40 vs. 56.21) (p < 0.01).
  
  
  
  In a large cohort of patients at a tertiary care hospital, we show an association of increased rate of RRS events in high-risk OSA patients and reduction of the risk with PAP intervention in the compliant group.
authors.affiliation: Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America.
authors.forename: Sunil
authors.initials: S
authors.lastname: Sharma
authors.affiliation: Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America.
authors.forename: Anindita
authors.initials: A
authors.lastname: Chowdhury
authors.affiliation: Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America.
authors.forename: Lili
authors.initials: L
authors.lastname: Tang
authors.affiliation: Willes Consulting Group Inc., Encinitas, California, United States of America.
authors.forename: Leslee
authors.initials: L
authors.lastname: Willes
authors.affiliation: Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America.
authors.forename: Brian
authors.initials: B
authors.lastname: Glynn
authors.affiliation: Harvard Medical School, Boston, Massachusetts, United States of America.|University of Arizona College of Medicine, Tucson, Arizona, United States of America.
authors.forename: Stuart F
authors.initials: SF
authors.lastname: Quan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D042241:Early Diagnosis; D005260:Female; D057209:Hospital Rapid Response Team / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data; D017286:Polysomnography; D012189:Retrospective Studies; D012306:Risk; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000503:physiopathology / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers; D014481:United States