Frequency of provision of CPAP in the inpatient setting: an observational study

Abstract

Background

Little is known about the rates of provision of CPAP in inpatient settings. A single prior “data mining” study using diagnostic and procedural codes concluded that 6% of people with sleep apnea receive CPAP when in the hospital. The purpose of this study is to reexamine the frequency with which people who have an established diagnosis of sleep apnea receive therapy for it when they are admitted to the hospital for other reasons.

Methods

A retrospective cohort study of 195 people with an existing diagnosis of obstructive sleep apnea admitted to a tertiary medical center from March 2009–July 2009. A logistic regression analysis was used to determine relative risk for provision of CPAP therapy controlling for the following variables: admission diagnosis, unit of admission (medical/surgical/psychiatric/pediatrics), length of stay, comorbidities, and patient characteristics (age/ race/ gender).

Results

Twenty-six percent of people with an established diagnosis of OSA received CPAP therapy during their hospitalization. In an additional 10%, therapy was offered but not implemented. Of the variables considered, only admission diagnosis of obesity (n = 3) was associated with an increased likelihood of receiving CPAP.

Conclusions

This rate of provision of CPAP to hospitalized patients, while low at 26%, is much higher than a previous study on this topic that estimated frequency of use of CPAP strictly linking diagnostic codes for OSA and procedural codes for CPAP.