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Early detection of obstructive sleep apnea in patients with atrial fibrillation.
Oster, Madeleine; Thornsberry, Joshua D; Howard, Lindsay A; Talley, Michele H.
Afiliación
  • Oster M; Center for Cardiovascular Health, Department of Cardiac Electrophysiology, Stanford Healthcare, Stanford, California.
  • Thornsberry JD; Center for Cardiovascular Care, Wellstar Health System, Hiram, Georgia.
  • Howard LA; Foothill Cardiology Medical Group, Inc., Pasadena, California.
  • Talley MH; The University of Alabama at Birmingham School of Nursing, Acute, Chronic, and Continuing Care Department, Birmingham, Alabama.
J Am Assoc Nurse Pract ; 34(9): 1083-1089, 2022 Sep 01.
Article en En | MEDLINE | ID: mdl-36083320
BACKGROUND: Obstructive sleep apnea (OSA) is an independent and modifiable risk factor for atrial fibrillation (AF) and correlates with a three-fold higher risk of incident AF. Although OSA is prevalent in patients with AF, it remains underdiagnosed. Guidelines for OSA screening are ambiguous. LOCAL PROBLEM: A small community hospital in the southeast United States lacked standardized OSA screening and consistent sleep clinic referral for hospitalized patients with AF. METHODS: Over 3 months, an OSA bundle (including screening, education, and referral) was implemented for hospitalized patients with AF. A retrospective electronic health record (EHR) review established a baseline comparison group. Descriptive analyses between the intervention and comparison groups evaluated the effectiveness of the OSA bundle. INTERVENTIONS: Eligible patients received OSA screening with the STOP-Bang questionnaire. A STOP-Bang score of 3 or higher triggered patient education about the arrhythmogenic relationship of OSA and AF. At discharge, patients received an ambulatory sleep clinic referral. After 3 months, an EHR review assessed the rate of sleep clinic follow-up, sleep testing, OSA diagnosis, and initiation of positive airway pressure. RESULTS: Of the 68 patients in the comparison group and 33 patients in the intervention group, the rate of OSA screening increased from 4.4% to 100%. Sleep clinic referral increased from 66.7% to 93.5%. Sleep clinic follow-up increased from 0% to 10%. CONCLUSION: Screening for OSA and sleep clinic referral improved with the OSA bundle; however, sleep clinic follow-up remained low. Further quantitative and qualitative investigation is needed to better understand barriers to sleep clinic follow-up.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibrilación Atrial / Apnea Obstructiva del Sueño Tipo de estudio: Diagnostic_studies / Guideline / Observational_studies / Qualitative_research / Risk_factors_studies / Screening_studies Límite: Humans Idioma: En Revista: J Am Assoc Nurse Pract Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibrilación Atrial / Apnea Obstructiva del Sueño Tipo de estudio: Diagnostic_studies / Guideline / Observational_studies / Qualitative_research / Risk_factors_studies / Screening_studies Límite: Humans Idioma: En Revista: J Am Assoc Nurse Pract Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos