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S23 Results Of A National Survey Of Pre-operative Screening For Obstructive Sleep Apnoea
  1. R Sharrock1,
  2. S Baudouin2,
  3. S West1
  1. 1Freeman Hospital, Newcastle Upon Tyne, UK
  2. 2Royal Victoria Infirmary, Newcastle Upon Tyne, UK

Abstract

Introduction and objectives There is currently no UK guidance (from BTS, BSS or RCA) regarding screening for obstructive sleep apnoea in the pre-operative setting. Evidence suggests that undiagnosed OSA is associated with increased post-operative complications but no trials have examined whether screening the UK’s general surgical population is justifiable. We sought to examine current UK practice and opinion in this regard.

Methods A postal survey was sent to all 180 UK sleep service providers asking whether they had a hospital policy for pre-operative screening for OSA and what this consisted of. If there was no policy they were asked how pre-operative patients with suspected OSA were identified. Further details regarding diagnostic confirmation and opinion regarding practice were sought.

Results We received 84 replies. There is a spectrum of current practice amongst respondents. There were 31 centres (37%) with a policy for screening for OSA. Of these, 42% screened all patients with a questionnaire e.g. STOP BANG, 23% screened only patients undergoing certain operations, 13% screened patients with high BMI only. Of those with a policy who estimated the number of referred patients, 60% saw more than >5 per month. Of centres with no policy only 26% estimated that they received >5 referrals per month. Without a policy 72% of referrals came from clinical suspicion alone.

Overall 96% of respondents felt that all patients at high risk of OSA should be screened for OSA. 36 respondents thought it would be ethical to randomise identified cases of OSA to a potential trial of peri-operative CPAP or no CPAP, compared with 40 who did not.

Conclusions There is no established UK standard practice for screening for OSA pre-operatively, despite a majority opinion amongst questionnaire responders that high risk patients should be. There would be cost implications if National pre-operative OSA screening was implemented and there therefore needs to be clear evidence based benefit before proceeding.

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