STUDY OBJECTIVES: To evaluate clinical recognition of sleep apnea and related outcomes in patients hospitalized with acute ischemic stroke. METHODS: A retrospective study of all patients hospitalized with acute ischemic stroke from April 2008 to December 2014. The primary predictor and outcome variables were sleep apnea and hospital mortality, respectively. Secondary outcomes were mechanical ventilation, hospital length of stay, and the survivor's functional level by the modified Rankin scale. A sensitivity multivariate regression analysis included the propensity score for cardiovascular comorbidities and sleep apnea. RESULTS: Of 989 patients, 190 (19%) were considered to have sleep apnea. Only 42 patients (22%) received any treatment for sleep apnea during the hospital stay. Despite higher prevalence of cardiovascular comorbidities, the patients with sleep apnea had lower hospital mortality, 1% versus 5.6% in patients without sleep apnea (odds ratio [OR] 0.18; 95% confidence interval [CI], 0.03-0.58, P = .002). Only the National Institutes of Health Stroke Scale (NIHSS) and the Glasgow coma scale (GCS) were significant predictors of adjusted hospital mortality (OR 1.06, 95% CI 1.01-1.11, P = .01 and OR 0.61, 95% CI 0.51-0.69, P ≤ .001, respectively). A composite clinical propensity score for sleep apnea and cardiovascular comorbidities was significantly associated with decreased mortality, independent to either NIHSS (OR 0.11, 95% CI 0.017-0.71; P = .02) or GCS (OR 0.07, 95% CI 0.01-0.52; P = .01). CONCLUSIONS: Prevalence of sleep apnea in our study was low, likely because of clinical underrecognition. Despite having more cardiovascular disease, the patients with acute stroke and sleep apnea had less severe neurological injury and lower unadjusted mortality than those without a history of sleep apnea.
STUDY OBJECTIVES: To evaluate clinical recognition of sleep apnea and related outcomes in patients hospitalized with acute ischemic stroke. METHODS: A retrospective study of all patients hospitalized with acute ischemic stroke from April 2008 to December 2014. The primary predictor and outcome variables were sleep apnea and hospital mortality, respectively. Secondary outcomes were mechanical ventilation, hospital length of stay, and the survivor's functional level by the modified Rankin scale. A sensitivity multivariate regression analysis included the propensity score for cardiovascular comorbidities and sleep apnea. RESULTS: Of 989 patients, 190 (19%) were considered to have sleep apnea. Only 42 patients (22%) received any treatment for sleep apnea during the hospital stay. Despite higher prevalence of cardiovascular comorbidities, the patients with sleep apnea had lower hospital mortality, 1% versus 5.6% in patients without sleep apnea (odds ratio [OR] 0.18; 95% confidence interval [CI], 0.03-0.58, P = .002). Only the National Institutes of Health Stroke Scale (NIHSS) and the Glasgow coma scale (GCS) were significant predictors of adjusted hospital mortality (OR 1.06, 95% CI 1.01-1.11, P = .01 and OR 0.61, 95% CI 0.51-0.69, P ≤ .001, respectively). A composite clinical propensity score for sleep apnea and cardiovascular comorbidities was significantly associated with decreased mortality, independent to either NIHSS (OR 0.11, 95% CI 0.017-0.71; P = .02) or GCS (OR 0.07, 95% CI 0.01-0.52; P = .01). CONCLUSIONS: Prevalence of sleep apnea in our study was low, likely because of clinical underrecognition. Despite having more cardiovascular disease, the patients with acute stroke and sleep apnea had less severe neurological injury and lower unadjusted mortality than those without a history of sleep apnea.
Authors: Susan Redline; Gayane Yenokyan; Daniel J Gottlieb; Eyal Shahar; George T O'Connor; Helaine E Resnick; Marie Diener-West; Mark H Sanders; Philip A Wolf; Estella M Geraghty; Tauqeer Ali; Michael Lebowitz; Naresh M Punjabi Journal: Am J Respir Crit Care Med Date: 2010-03-25 Impact factor: 21.405
Authors: Michael Arzt; Terry Young; Laurel Finn; James B Skatrud; T Douglas Bradley Journal: Am J Respir Crit Care Med Date: 2005-09-01 Impact factor: 21.405
Authors: David S C Hui; Dominic K L Choy; Lawrence K S Wong; Fanny W S Ko; Thomas S T Li; Jean Woo; Richard Kay Journal: Chest Date: 2002-09 Impact factor: 9.410
Authors: Susanne Wegener; Barbara Gottschalk; Verica Jovanovic; René Knab; Jochen B Fiebach; Peter D Schellinger; Thomas Kucinski; Gerhard J Jungehülsing; Peter Brunecker; Bianca Müller; Anna Banasik; Nicola Amberger; Klaus D Wernecke; Mario Siebler; Joachim Röther; Arno Villringer; Markus Weih Journal: Stroke Date: 2004-02-12 Impact factor: 7.914
Authors: Ivana Rosenzweig; Matthew J Kempton; William R Crum; Martin Glasser; Milan Milosevic; Sandor Beniczky; Douglas R Corfield; Steven C Williams; Mary J Morrell Journal: PLoS One Date: 2013-12-13 Impact factor: 3.240
Authors: Michael T Saletu; Stefan T Kotzian; Angela Schwarzinger; Sandra Haider; Josef Spatt; Bernd Saletu Journal: J Clin Sleep Med Date: 2018-09-15 Impact factor: 4.062
Authors: Rodrigo Jiménez-García; Ana López-de-Andrés; Javier de-Miguel-Diez; Marta Lopez-Herranz; Valentín Hernandez-Barrera; David Jimenez; Manuel Monreal Journal: Sci Rep Date: 2021-09-15 Impact factor: 4.379