Association between sleep apnea and perioperative outcomes among patients undergoing shoulder arthroscopy

Abstract

Purpose

Sleep apnea is a recognized risk factor for adverse perioperative outcomes in total joint arthroplasty. Nevertheless, little is known about its impact on shoulder arthroscopy, which is a commonly performed ambulatory procedure. Our primary objective was to determine whether sleep apnea was associated with increases in complications and healthcare utilization in this setting.

Methods

We analyzed administrative data collected from 583 U.S. hospitals between 2010-2015 and identified a cohort of 128,932 patients who underwent shoulder arthroscopy. Using a cross-sectional study design, we examined the relationship between sleep apnea and perioperative outcomes including mortality, stroke, myocardial infarction, and pulmonary complications. We also examined a variety of health utilization outcomes.

Results

Among patients who underwent shoulder arthroscopy, approximately 6% (7,761 of 128,932) had the diagnosis of sleep apnea. The overall complication rate in these patients was 1.39% (95% confidence interval [CI], 1.33 to 1.45). In a crude analysis, sleep apnea was associated with increases in the majority of systemic complications. In adjusted analyses, sleep apnea was associated with a 4.95 (95% CI, 1.81 to 13.5) times greater odds of acute myocardial infarction and a 4.92 (95% CI, 2.72 to 8.9) times greater odds of pulmonary complications. Sleep apnea was also associated with increased odds of requiring postoperative ventilation, hospital admission, and intensive care unit admission.

Conclusion

Sleep apnea is associated with an increased risk of complications and resource utilization in patients undergoing shoulder arthroscopy.

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