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Importance of Screening for OSA Prior to Surgery

If you don't have a standardized process for obstructive sleep apnea screening of all patients heading into the operating room at your hospital you should, because perioperative pulmonary complications can occur, according to Efren C. Manjarrez MD, SFHM, FACP.

Dr Efren Manjarrez

If OSA is not documented in the patient's chart, you may find yourself making a bedside assessment. "I usually don't ask the patients this because they can't necessarily answer the questions," Manjarrez, associate professor in the division of hospital medicine at the University of Miami, said at SHM Converge, the annual conference of the Society of Hospital Medicine. "So, I ask their partner: 'Does your partner snore loudly? Are they sleepy during the daytime, or are they gasping or choking in the middle of the night?'"

The following factors have a relatively high specificity for OSA: a STOP-Bang score of 5 or greater, a STOP-Bang score of 2 or greater plus male gender, and a STOP-Bang score of 2 or greater plus a body mass index greater than 35 kg/m2. Clinicians can also check the Mallampati score on their patients by having them tilt their heads back and stick out their tongues.

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