Increased Stop Bang Score does not predict increased perioperative risk in patients with sleep apnea undergoing total knee arthroplasty.
Academic Article
Overview
abstract
INTRODUCTION: In patients undergoing total knee arthroplasty (TKA) obstructive sleep apnea (OSA) is common. Our retrospective study aimed to investigate whether perioperative outcome differ between patients with low-moderate OSA risk and patients with high OSA risk and whether the perioperative outcomes of patients with and without CPAP (continuous positive airway pressure) device differ. MATERIALS AND METHODS: After excluding patients (missing STOP-Bang-Score, concomitant lung disease) 1444 TKA operated between 2016 and 2020 were included. The STOP-Bang Score was used to determine the risk for OSA (low-moderate risk: Score 0-4, high risk: Score 5-8). SpO2 drops < 90% and readmission rates were compared for low-moderate risk patients and high risk patients as well as for patients with and without CPAP. RESULTS: There was no difference in SpO2-drops < 90% (1% vs. 1% P = 0.612) and readmission rate (4% vs. 3%, P = 0.537) between low-moderate risk (409 TKA) and high risk patients (1035 TKA). A significant reduction in O2 Flow-Rate (P < 0.001) and no difference in SpO2 (P > 0.999) was observed from post anesthesia care unit to the morning of postoperative day one for both groups. 47% (677/1444) utilized a CPAP machine. There was no difference in the incidence of SpO2 drops < 90% (1% vs. 1%, P = 0.605) and readmission rate (3% vs. 5%, P = 0.055) between both groups. CONCLUSION: In the absence of underlying pulmonary disease perioperative outcomes did not differ between TKA patients with a low- moderate OSA risk and patients with a high OSA risk according to the STOP Bang Score regardless of the use of a CPAP machine. Outpatient TKA might be an option for optimized OSA patients (without underlying pulmonary disease) regardless of STOP Bang Score and use of a CPAP machine.
