Disparities in polysomnography referral in a high-risk cardiac population. Sleep Breath 2024 Jun 18
Date
06/19/2024Pubmed ID
38890269DOI
10.1007/s11325-024-03051-yScopus ID
2-s2.0-85196291059 (requires institutional sign-in at Scopus site)Abstract
PURPOSE: Obstructive sleep apnea (OSA) is associated with metabolic, cardiovascular, and cerebrovascular comorbidities. Appropriate diagnosis and treatment of OSA might mitigate these comorbidities. This retrospective review sought to assess the impact of sex, age, race, ethnicity, and insurance status on polysomnography (PSG) referral rates.
METHODS: An institutional STOP-Bang database of 299,320 patients was filtered for patients admitted to the hospital with an acute cardiac diagnosis between 2015-2020. A cohort of 4,735 patients were risk stratified by STOP-Bang (SB) score and correlations were made between PSG referrals and demographic and clinical variables (sex, age, race, ethnicity, and insurance status).
RESULTS: Of the 25.3% of the cohort with high SB scores (5-8) only 21.3% were referred for PSG. Age and female sex were negatively associated with sleep study referrals (p < 0.001). No correlation was found between sleep study referral rates and race or ethnicity. No correlation was found between sleep study referrals and insurance provider. Admitting cardiac diagnosis significantly influenced sleep study referrals with diagnoses of arrhythmias and myocardial infarction being associated with an increased rate of PSG referrals compared to heart failure patients (p < 0.002).
CONCLUSIONS: Our study found no significant correlation between PSG referral rates and race, ethnicity, or insurance provider. However, we found low overall rates of PSG referral, with negative correlations between older age and female sex and a high-risk cardiac population. This represents a substantial missed opportunity to identify patients at risk for OSA, obtain a diagnosis, and provider adequate treatment.
Author List
Koss KR, Kumar D, Friedland DR, Adams JA, Lauer KK, Tong L, Luo J, Woodson BTAuthors
David R. Friedland MD Associate Director, Director, Chief, Professor in the Otolaryngology department at Medical College of WisconsinKathryn K. Lauer MD Vice Chair, Professor in the Anesthesiology department at Medical College of Wisconsin
Jake Luo Ph.D. Associate Professor; Director, Center for Biomedical Data and Language Processing (BioDLP) in the Health Informatics & Administration department at University of Wisconsin - Milwaukee
