Impact on clinical outcomes, surgical interventions, anaesthetic decisions and complication rates following implementation of the NICE obstructive sleep apnoea guidelines during preoperative screening
2024

Impact of NICE Guidelines on Sleep Apnoea Screening Before Surgery

Sample size: 450 publication 10 minutes Evidence: moderate

Author Information

Author(s): Gabrielle Shaw, Ricki Leggatt, Paige Roberts, Amanda Peace Witton, Nicole Moll, Akshay Dwarakanath

Primary Institution: Mid Yorkshire Teaching NHS Trust

Hypothesis

The implementation of NICE guidelines will increase the prevalence of identified obstructive sleep apnoea (OSA) in surgical patients and affect surgical decisions.

Conclusion

The study found that a high prevalence of OSA in presurgical patients impacts surgical decisions and anaesthetic plans, highlighting the need for timely CPAP initiation.

Supporting Evidence

  • 32% of patients had normal oximetry results, while 9% had severe OSA.
  • Patients with moderate/severe OSA had a higher likelihood of surgical delays.
  • CPAP therapy was initiated in a third of patients preoperatively.

Takeaway

Many patients going for surgery have sleep problems that can cause complications, but doctors can help by checking for these issues before the surgery.

Methodology

The study evaluated the impact of NICE guidelines on clinical outcomes in surgical patients with suspected OSA using a STOP-Bang score for screening and overnight oximetry for diagnosis.

Potential Biases

The study may have bias due to its retrospective nature and reliance on self-reported data for screening.

Limitations

The study was retrospective, had missing data, and only included patients scheduled for elective surgery, potentially underestimating the true prevalence of OSA.

Participant Demographics

The average age was 55 years, with 69% male and a mean BMI of 32.

Statistical Information

P-Value

p<0.0001

Confidence Interval

95% CI = 2.39–6.02

Statistical Significance

p<0.0001

Digital Object Identifier (DOI)

10.1016/j.clinme.2024.100266

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