• Reena Dhanda Patil and Yash J Patil.
• University of Cincinnati Department of Otolaryngology-Head and Neck Surgery, Cincinnati, Ohio, USA. reenadhanda@aol.com
• Otolaryngol Head Neck Surg. 2012 Jan 1;146(1):156-61.

Objectives/Hypothesis(1) To determine the presence of Veterans Affairs (VA) institutional guidelines for the perioperative management of obstructive sleep apnea (OSA); (2) to examine current use of preoperative screening tools for OSA in the VA; and (3) to understand current VA practice patterns regarding postoperative disposition of patients with OSA.Study DesignSurvey study.SettingVeterans Affairs hospitals with surgical services; sample size 102 facilities.SubjectsVeterans Affairs health care providers.MethodsThe authors surveyed health care providers at VA hospitals using a survey tool developed by the authors.ResultsThe response rate was 80%. A variety of preoperative screening tools for OSA were used by respondents, most commonly American Society of Anesthesiologists guidelines (53%). A policy for postoperative disposition of known and presumed OSA was present in 26% and 19% of responses, respectively. Of those respondents reporting a formal postoperative care policy, 48% and 30% admitted patients to a monitored ward bed and surgical intensive care unit, respectively. Of the 74% of respondents unaware of an institutional policy, Anesthesia and Surgery worked together to dictate postoperative disposition of patients with known OSA 73% of the time. The degree of OSA was ranked as the most important factor (58%) influencing postoperative disposition. Ten percent of respondents reported a major perioperative complication attributable to OSA in the past year.ConclusionThis survey study elucidates the heterogeneity of preoperative screening for and postoperative care of veterans with OSA. Future investigators may use these data to formalize institutional policies with regard to patients with OSA, with potentially significant impacts on patient care and usage of financial resources.

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