• Justin W Griffin, Wendy M Novicoff, James A Browne, and Stephen F Brockmeier.
• Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA, USA.
• J Shoulder Elbow Surg. 2013 Dec 1;22(12):e6-9.

BackgroundObstructive sleep apnea (OSA) has been identified as an important risk factor in perioperative orthopaedic surgery outcomes despite limited evidence. Screening systems are being instituted in increasing frequency to prevent morbidity and mortality. Our objective was to determine if patients with OSA have a higher likelihood of postoperative in-hospital complications, length of stay, or increased costs after shoulder arthroplasty.MethodsWe utilized the Nationwide Inpatient Sample (NIS) to analyze 22988 patients undergoing TSA or hemiarthroplasty. Of these patients, 1983 (5.9%) were diagnosed with OSA. Multivariate analysis with logistic regression modeling was used to compare patients with and without OSA for various outcomes.ResultsPatients with obstructive sleep apnea had overall similar in-hospital mortality and complications including PE compared with those without OSA. OSA was not associated with increased postoperative charges ($39,741 in patients with OSA vs. $39,334 in those without OSA) and resulted in a shorter length of stay (mean, 2.61 vs. 2.91 days; P < .0001).ConclusionThis study does not support OSA as a significant risk factor for in-hospital morbidity and mortality following shoulder arthroplasty. Our results suggest that a diagnosis of OSA does not increase perioperative morbidity and mortality including perioperative complications. Given the results of this study, further research is warranted to attempt to keep patient screening costs down while optimizing outcomes.Copyright © 2013 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

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