The Impact of Osa on the Outcomes of Patients Admitted With a Myocardial Infarction

Исмаилов, Е.Л.; Rose-Reneau, Zak; Arellanes, Russell; Dang, Andrew; Schirmer, Derek

doi:10.1016/j.chest.2019.08.397

Cited by 1 publication

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“…These findings were confirmed independently in a more recent study [ 35 ]. Similarly, other recent publications involving patients hospitalized for myocardial infarction [ 25 , 27 ], pulmonary embolism [ 29 ] and critically ill patients [ 36 ], showed a decrease of in-hospital mortality associated with diagnosed SA. The mechanisms underlying these findings are incompletely understood.…”

Section: Discussionsupporting

confidence: 55%

“…The outcome of hospitalized patients with SA has only been scarcely investigated and is still controversial [ 24 , 25 ]. Patients with SA typically have a greater burden of comordities, use more hospital resources [ 26 ] but, for certain conditions (including myocardial infarction, pneumonia, pulmonary embolism), have a lower inpatient mortality [ 25 , 27 – 29 ].…”

Section: Introductionmentioning

confidence: 99%

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In-hospital survival paradox in patients with sleep apnea—A nation-wide nested case-control study

Moser

Baty²,

Brutsche³

et al. 2022

PLoS ONE

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Background Sleep apnea (SA) is a prevalent disorder characterized by recurrent events of nocturnal apnea originating from obstructive and/or central mechanisms. SA disrupts normal sleep and can lead to a series of complications when left untreated. SA results in intermittent hypoxia which has an impact on the cardio- and cerebrovascular system. Hospitalized patients with SA typically have a greater burden of comorbidity, a longer length of hospital stay, but may show an improvement of in-hospital mortality compared to patients without diagnosed SA. The reason for this survival benefit is controversial and we aimed to clarify this protective effect in the light of predictive factors including SA-associated comorbidities using a nation-wide hospitalization database. Methods and findings Data were extracted from a nation-wide hospitalization database provided by the Swiss Federal Office for Statistics. Hospitalized patients with a SA co-diagnosis were extracted from the database together with a 1:1-matched control population without SA. Overall, 212’581 patients with SA were hospitalized in Switzerland between 2002 and 2018. Compared to the controls, SA cases had a longer median length of hospital stay (7 days; 95% CI: 3 to 15 vs. 4 days; 95% CI: 2 to 10) (p < 0.001) and a higher median number of comorbidities (8 comorbidities; IQR: 5 to 11 vs. 3 comorbidities; IQR: 1 to 6) (p < 0.001). The risk of in-hospital mortality was lower in the SA cases compared to the controls (OR: 0.73; 95% CI: 0.7 to 0.76; p < 0.001). SA was associated with a survival benefit in hospitalizations related to 28 of 47 conditions with the highest rate of in-hospital death. Sixty-three comorbidities were significantly over-represented in SA cases among which obesity, hypertension and anatomic nasal deviations were associated with a significant decrease of in-hospital mortality. Conclusions Compared to matched controls, SA was associated with significant and relevant inpatient survival benefit in a number of most deadly conditions. Within SA-patients, associated comorbidities mostly correlated with a poorer prognosis, whereas obesity and hypertension were associated with an improved in-hospital mortality.

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