The prevalence of obstructive sleep apnea (OSA) in the intensive care unit (ICU) has been reported between 6-10%. There is limited data whether there is any mortality impact of OSA in critical care setting. The purpose of this study is to compare in-hospital mortality between patients wiith versus without OSA who required invasive mechanical ventilation (IMV). METHODS: We performed a retrospective cohort study in subjects who admitted in critical care units using Medical Information Mart for Intensive Care-III (MIMIC-III) database. All patients who required IMV were included. Patients were categorized into OSA and non-OSA group. Demgraphic data, comorbidities, length of IMV, hospital length of stay (LOS), Simplified Acute Physiology Scores-II (SAPS-II), in-hospital mortality were collected. Propensity score-matched analysis for gender, ethnicity and SAPS-II was performed. RESULTS: There were 923 and 20,464 patients with OSA and without OSA, respectively. In-hospital mortality were 17.6% in total, 8.7% and 18% in OSA and non-OSA group, respectively (p<0.01). There was no significant difference of ventilator duration or hospital LOS. After propensity score matching was performed, the in-hospital mortality were 8.7% and 15.3% in OSA and non-OSA group, respectively (p<0.01). Median ventilator duration were 17.3 and 19.0 hours in OSA and non-OSA group, respectively (p¼0.35). Median hospital LOS were 10.1 and 9.7 days in OSA and non-OSA group, respectively (p¼0.53). CONCLUSIONS: Critically-ill patients who required IMV with OSA had lower in-hospital mortality than patients without OSA. CLINICAL IMPLICATIONS: This result might help decreasing hesitancy to place IMV in critically-ill OSA patients.

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