{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:17:14Z","timestamp":1787019434201,"version":"build-2736575974"},"reference-count":24,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T00:00:00Z","timestamp":1743120000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T00:00:00Z","timestamp":1743120000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Study design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To examine differences in postoperative complications, recovery course, and costs between patients with and without obstructive sleep apnea (OSA) undergoing single-level anterior cervical discectomy and fusion (ACDF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The National Inpatient Sample (NIS) database was queried to identify patients undergoing single-level ACDF between 2016 and 2022. After exclusions, patients were divided into OSA and control groups. Propensity score matching (1:2) controlled for age, sex, obesity, and year of surgery to balance characteristics. Postoperative outcomes, including complications, length of stay (LOS), hospital costs, and discharge disposition, were compared using chi-square tests for categorical variables and t-tests for continuous variables. A Bonferroni correction was applied, with significance set at\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.002.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 36,000 matched cases were analyzed (12,000 OSA and 24,000 controls). OSA patients had significantly higher rates of acute respiratory failure (4.7% vs 1.9%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) and mechanical ventilation (1.5% vs 0.6%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). The OSA cohort also had a longer LOS (2.3 vs 1.9 days;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), higher hospital costs ($23,300 vs $21,100;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), and greater non-routine discharge rates (20.4% vs 16.8%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>OSA is associated with increased respiratory complications, prolonged LOS, and higher costs in single-level ACDF. These findings underscore the importance of preoperative screening and tailored perioperative management to improve outcomes in this high-risk population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682251333324","type":"journal-article","created":{"date-parts":[[2025,3,29]],"date-time":"2025-03-29T11:10:44Z","timestamp":1743246644000},"page":"3827-3833","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Obstructive Sleep Apnea is Associated With Increased Rates of Acute Respiratory Failure, Length of Stay, and Hospital Costs in Patients Undergoing Elective Single-Level Anterior Cervical Discectomy and Fusion"],"prefix":"10.1177","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1196-517X","authenticated-orcid":false,"given":"Paul G.","family":"Mastrokostas","sequence":"first","affiliation":[{"name":"SUNY Downstate Health Sciences University"},{"name":"Maimonides Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Said","sequence":"additional","affiliation":[{"name":"SUNY Downstate Health Sciences University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Cassar","sequence":"additional","affiliation":[{"name":"SUNY Downstate Health Sciences University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8926-3502","authenticated-orcid":false,"given":"Leonidas E.","family":"Mastrokostas","sequence":"additional","affiliation":[{"name":"SUNY Downstate Health Sciences University"},{"name":"Maimonides Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron B.","family":"Lavi","sequence":"additional","affiliation":[{"name":"SUNY Downstate Health Sciences University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arya","family":"Varthi","sequence":"additional","affiliation":[{"name":"Yale New Haven Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jad","family":"Bou Monsef","sequence":"additional","affiliation":[{"name":"SUNY Downstate Health Sciences University"},{"name":"Maimonides Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afshin E.","family":"Razi","sequence":"additional","affiliation":[{"name":"Maimonides Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5831-055X","authenticated-orcid":false,"given":"Mitchell K.","family":"Ng","sequence":"additional","affiliation":[{"name":"Maimonides Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,3,28]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2017.10.072"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.21037\/jss.2019.12.04"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2017.04.017"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/2192568217722562"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2022.107245"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20210817-08"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2024.01.045"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kws342"},{"issue":"5","key":"e_1_3_3_10_2","first-page":"246","article-title":"Burden of sleep apnea: rationale, design, and major findings of the Wisconsin Sleep Cohort study","volume":"108","author":"Young T","year":"2009","unstructured":"Young T, Palta M, Dempsey J, Peppard PE, Nieto FJ, Hla KM. Burden of sleep apnea: rationale, design, and major findings of the Wisconsin Sleep Cohort study. Wis Med J. 2009;108(5):246-249.","journal-title":"Wis Med J"},{"key":"e_1_3_3_11_2","unstructured":"HCUP-US NIS overview. https:\/\/hcup-us.ahrq.gov\/nisoverview.jsp"},{"key":"e_1_3_3_12_2","unstructured":"Inflation calculator find US dollar\u2019s value from 1913-2024. https:\/\/www.usinflationcalculator.com\/"},{"key":"e_1_3_3_13_2","unstructured":"Elixhauser comorbidity software refined for ICD-10-CM. https:\/\/hcup-us.ahrq.gov\/toolssoftware\/comorbidityicd10\/comorbidity_icd10.jsp"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000005212"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-013-3046-4"},{"issue":"10","key":"e_1_3_3_16_2","first-page":"1440","article-title":"Influence of head extension, flexion, and rotation on collapsibility of the passive upper airway","volume":"31","author":"Walsh JH","year":"2008","unstructured":"Walsh JH, Maddison KJ, Platt PR, Hillman DR, Eastwood PR. Influence of head extension, flexion, and rotation on collapsibility of the passive upper airway. Sleep. 2008;31(10):1440-1447.","journal-title":"Sleep"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcdt.2015.05.010"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000005444"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2024.108505"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-17-00561"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000002041"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.14444\/8324"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000000040"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.4783"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000000841"}],"container-title":["Global Spine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21925682251333324","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/21925682251333324","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21925682251333324","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:15:47Z","timestamp":1777446947000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/21925682251333324"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,28]]},"references-count":24,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1177\/21925682251333324"],"URL":"https:\/\/doi.org\/10.1177\/21925682251333324","relation":{},"ISSN":["2192-5682","2192-5690"],"issn-type":[{"value":"2192-5682","type":"print"},{"value":"2192-5690","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,28]]}}}