Obstructive sleep apnea as an independent predictor of postoperative delirium and pain: protocol for an observational study of a surgical cohort [version 2; referees: 2 approved]

Introduction: Postoperative delirium and pain are common complications in adults, and are difficult both to prevent and treat. Obstructive sleep apnea (OSA) is prevalent in surgical patients, and has been suggested to be a risk factor for postoperative delirium and pain. OSA also might impact pain p...

Full description

Bibliographic Details
Main Authors: Patricia Strutz, William Tzeng, Brianna Arrington, Vanessa Kronzer, Sherry McKinnon, Arbi Ben Abdallah, Simon Haroutounian, Michael S. Avidan
Format: Article
Language:English
Published: F1000 Research Ltd 2018-06-01
Series:F1000Research
Online Access:https://f1000research.com/articles/7-328/v2
_version_ 1819177530395983872
author Patricia Strutz
William Tzeng
Brianna Arrington
Vanessa Kronzer
Sherry McKinnon
Arbi Ben Abdallah
Simon Haroutounian
Michael S. Avidan
author_facet Patricia Strutz
William Tzeng
Brianna Arrington
Vanessa Kronzer
Sherry McKinnon
Arbi Ben Abdallah
Simon Haroutounian
Michael S. Avidan
author_sort Patricia Strutz
collection DOAJ
description Introduction: Postoperative delirium and pain are common complications in adults, and are difficult both to prevent and treat. Obstructive sleep apnea (OSA) is prevalent in surgical patients, and has been suggested to be a risk factor for postoperative delirium and pain. OSA also might impact pain perception, and alter pain medication requirements. This protocol describes an observational study, with the primary aim of testing whether OSA is an independent predictor of postoperative complications, focusing on (i) postoperative incident delirium and (ii) acute postoperative pain severity. We secondarily hypothesize that compliance with prescribed treatment for OSA (typically continuous positive airway pressure or CPAP) might decrease the risk of delirium and the severity of pain. Methods and analysis: We will include data from patients who have been enrolled into three prospective studies: ENGAGES, PODCAST, and SATISFY-SOS. All participants underwent general anesthesia for a non-neurosurgical inpatient operation, and had a postoperative hospital stay of at least one day at Barnes Jewish Hospital in St. Louis, Missouri, from February 2013 to May 2018.  Patients included in this study have been assessed for postoperative delirium and pain severity as part of the parent studies. In the current study, determination of delirium diagnosis will be based on the Confusion Assessment Method, and the Visual Analogue Pain Scale will be used for pain severity. Data on OSA diagnosis, OSA risk and compliance with treatment will be obtained from the preoperative assessment record. Other variables that are candidate risk factors for delirium and pain will also be extracted from this record. We will use logistic regression to test whether OSA independently predicts postoperative delirium and linear regression to assess OSAs relationship to acute pain severity. We will conduct secondary analyses with subgroups to explore whether these relationships are modified by compliance with OSA treatment.
first_indexed 2024-12-22T21:28:07Z
format Article
id doaj.art-1518c476cbda4682b1e045ee9ca63f70
institution Directory Open Access Journal
issn 2046-1402
language English
last_indexed 2024-12-22T21:28:07Z
publishDate 2018-06-01
publisher F1000 Research Ltd
record_format Article
series F1000Research
spelling doaj.art-1518c476cbda4682b1e045ee9ca63f702022-12-21T18:12:00ZengF1000 Research LtdF1000Research2046-14022018-06-01710.12688/f1000research.14061.216543Obstructive sleep apnea as an independent predictor of postoperative delirium and pain: protocol for an observational study of a surgical cohort [version 2; referees: 2 approved]Patricia Strutz0William Tzeng1Brianna Arrington2Vanessa Kronzer3Sherry McKinnon4Arbi Ben Abdallah5Simon Haroutounian6Michael S. Avidan7Department of Anesthesiology, Washington University School of Medicine, Saint Louis, MO, 63110, USADepartment of Anesthesiology, Washington University School of Medicine, Saint Louis, MO, 63110, USADepartment of Anesthesiology, Washington University School of Medicine, Saint Louis, MO, 63110, USADepartment of Anesthesiology, Washington University School of Medicine, Saint Louis, MO, 63110, USADepartment of Anesthesiology, Washington University School of Medicine, Saint Louis, MO, 63110, USADepartment of Anesthesiology, Washington University School of Medicine, Saint Louis, MO, 63110, USADepartment of Anesthesiology, Washington University School of Medicine, Saint Louis, MO, 63110, USADepartment of Anesthesiology, Washington University School of Medicine, Saint Louis, MO, 63110, USAIntroduction: Postoperative delirium and pain are common complications in adults, and are difficult both to prevent and treat. Obstructive sleep apnea (OSA) is prevalent in surgical patients, and has been suggested to be a risk factor for postoperative delirium and pain. OSA also might impact pain perception, and alter pain medication requirements. This protocol describes an observational study, with the primary aim of testing whether OSA is an independent predictor of postoperative complications, focusing on (i) postoperative incident delirium and (ii) acute postoperative pain severity. We secondarily hypothesize that compliance with prescribed treatment for OSA (typically continuous positive airway pressure or CPAP) might decrease the risk of delirium and the severity of pain. Methods and analysis: We will include data from patients who have been enrolled into three prospective studies: ENGAGES, PODCAST, and SATISFY-SOS. All participants underwent general anesthesia for a non-neurosurgical inpatient operation, and had a postoperative hospital stay of at least one day at Barnes Jewish Hospital in St. Louis, Missouri, from February 2013 to May 2018.  Patients included in this study have been assessed for postoperative delirium and pain severity as part of the parent studies. In the current study, determination of delirium diagnosis will be based on the Confusion Assessment Method, and the Visual Analogue Pain Scale will be used for pain severity. Data on OSA diagnosis, OSA risk and compliance with treatment will be obtained from the preoperative assessment record. Other variables that are candidate risk factors for delirium and pain will also be extracted from this record. We will use logistic regression to test whether OSA independently predicts postoperative delirium and linear regression to assess OSAs relationship to acute pain severity. We will conduct secondary analyses with subgroups to explore whether these relationships are modified by compliance with OSA treatment.https://f1000research.com/articles/7-328/v2
spellingShingle Patricia Strutz
William Tzeng
Brianna Arrington
Vanessa Kronzer
Sherry McKinnon
Arbi Ben Abdallah
Simon Haroutounian
Michael S. Avidan
Obstructive sleep apnea as an independent predictor of postoperative delirium and pain: protocol for an observational study of a surgical cohort [version 2; referees: 2 approved]
F1000Research
title Obstructive sleep apnea as an independent predictor of postoperative delirium and pain: protocol for an observational study of a surgical cohort [version 2; referees: 2 approved]
title_full Obstructive sleep apnea as an independent predictor of postoperative delirium and pain: protocol for an observational study of a surgical cohort [version 2; referees: 2 approved]
title_fullStr Obstructive sleep apnea as an independent predictor of postoperative delirium and pain: protocol for an observational study of a surgical cohort [version 2; referees: 2 approved]
title_full_unstemmed Obstructive sleep apnea as an independent predictor of postoperative delirium and pain: protocol for an observational study of a surgical cohort [version 2; referees: 2 approved]
title_short Obstructive sleep apnea as an independent predictor of postoperative delirium and pain: protocol for an observational study of a surgical cohort [version 2; referees: 2 approved]
title_sort obstructive sleep apnea as an independent predictor of postoperative delirium and pain protocol for an observational study of a surgical cohort version 2 referees 2 approved
url https://f1000research.com/articles/7-328/v2
work_keys_str_mv AT patriciastrutz obstructivesleepapneaasanindependentpredictorofpostoperativedeliriumandpainprotocolforanobservationalstudyofasurgicalcohortversion2referees2approved
AT williamtzeng obstructivesleepapneaasanindependentpredictorofpostoperativedeliriumandpainprotocolforanobservationalstudyofasurgicalcohortversion2referees2approved
AT briannaarrington obstructivesleepapneaasanindependentpredictorofpostoperativedeliriumandpainprotocolforanobservationalstudyofasurgicalcohortversion2referees2approved
AT vanessakronzer obstructivesleepapneaasanindependentpredictorofpostoperativedeliriumandpainprotocolforanobservationalstudyofasurgicalcohortversion2referees2approved
AT sherrymckinnon obstructivesleepapneaasanindependentpredictorofpostoperativedeliriumandpainprotocolforanobservationalstudyofasurgicalcohortversion2referees2approved
AT arbibenabdallah obstructivesleepapneaasanindependentpredictorofpostoperativedeliriumandpainprotocolforanobservationalstudyofasurgicalcohortversion2referees2approved
AT simonharoutounian obstructivesleepapneaasanindependentpredictorofpostoperativedeliriumandpainprotocolforanobservationalstudyofasurgicalcohortversion2referees2approved
AT michaelsavidan obstructivesleepapneaasanindependentpredictorofpostoperativedeliriumandpainprotocolforanobservationalstudyofasurgicalcohortversion2referees2approved