Clinical Adult Literature Updates from September 2013

Cost Savings Associated With an Education Campaign on the Diagnosis and Management of Sleep-Disordered Breathing: A Retrospective, Claims-Based US Study

The study was to determine if medical expenses of members enrolled in the not-for-profit, US-based Union Pacific Railroad Employes Health Systems (UPREHS) health plan were reduced after implementing a low-cost, patient-focused education campaign on sleep-disordered breathing (SDB). A differential cost savings of $4.9 million for the study period was shown. These findings suggest that an SDB education campaign can improve health care outcomes and reduce medical expenses.

The Association of Pre-Operative STOP-BANG Scores with Postoperative Critical Care Admission

The STOP-BANG questionnaire screens for obstructive sleep apnoea. In multivariate analysis, the odds ratios (95% CI) for critical care admission were: 2.2 (1.1–4.6), p = 0.037; 3.2 (1.2–8.1), p = 0.017; and 5.1 (1.8–14.9), p = 0.002, for STOP-BANG scores of 4, 5 and ≥ 6, respectively.

Perioperative Risk and Management in Patients with Pulmonary Hypertension

In this review the authors describe how the “understanding the pathophysiology, cause, and severity of PH in the individual perioperative patient allows accurate risk assessment, optimization of PH and RV function prior to surgery, and appropriate intraoperative and postoperative management.”

Association Between Obstructive Sleep Apnea and Pulmonary Embolism

The authors sought “to compare the prevalence of obstructive sleep apnea (OSA) in patients with pulmonary embolism (PE) with a sex-, age-, and body mass index (BMI)-matched, population-based control group and to assess the association between OSA and PE. A higher prevalence of OSA was detected in patients diagnosed as having acute PE than controls. This study identified a significant and independent association between OSA and PE.”