Shojiro Oka1, Tadahiro Goto2, Atsushi Hirayama3, Mohammad Kamal Faridi4, Carlos A Camargo4, Kohei Hasegawa4. 1. Department of Emergency Medicine, Okinawa Prefectural Chubu Hospital, Okinawa, Japan. 2. Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts; Graduate School of Medical Sciences, University of Fukui, Fukui, Japan; Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan. Electronic address: tag695@mail.harvard.edu. 3. Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts; Department of Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan. 4. Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts.
Abstract
BACKGROUND: Studies suggest that obstructive sleep apnea (OSA) is associated with suboptimal disease control and worse chronic severity of asthma. However, little is known about the relations of OSA with acute asthma severity in hospitalized patients. OBJECTIVE: To investigate the association of OSA with acute asthma severity. METHODS: This is a retrospective cohort study (2010-2013) using State Inpatient Databases from 8 geographically diverse states in the United States. The outcomes were markers of acute severity, including mechanical ventilation use, hospital length of stay, and in-hospital mortality. To determine the association of interest, we fit multivariable logistic regression models, adjusting for age, sex, race/ethnicity, primary insurance, household income, patient residence, comorbidities, hospital state, and hospitalization year. We repeated the analysis for children aged 6 to 17 years. RESULTS: Among 73,408 adult patients hospitalized for acute asthma, 10.3% had OSA. Coexistent OSA was associated with a significantly higher risk of noninvasive positive pressure ventilation use (14.9% vs 3.1%; unadjusted odds ratio, 6.48; 95% CI, 5.88-7.13; adjusted odds ratio, 5.20; 95% CI, 4.65-5.80), whereas coexistent OSA was not significantly associated with the risk of invasive mechanical ventilation use. Patients with OSA had 37% longer hospital length of stay (unadjusted incidence rate ratio, 1.37; 95% CI, 1.33-1.40); this significant association persisted in the multivariable model (incidence rate ratio, 1.13; 95% CI, 1.10-1.17). The in-hospital mortality did not significantly differ between groups. These findings were consistent in both obesity and nonobesity groups and in 27,935 children. CONCLUSION: Among patients hospitalized for acute asthma, OSA was associated with a higher risk of noninvasive positive pressure ventilation use and longer length of stay compared with those without OSA.
BACKGROUND: Studies suggest that obstructive sleep apnea (OSA) is associated with suboptimal disease control and worse chronic severity of asthma. However, little is known about the relations of OSA with acute asthma severity in hospitalized patients. OBJECTIVE: To investigate the association of OSA with acute asthma severity. METHODS: This is a retrospective cohort study (2010-2013) using State Inpatient Databases from 8 geographically diverse states in the United States. The outcomes were markers of acute severity, including mechanical ventilation use, hospital length of stay, and in-hospital mortality. To determine the association of interest, we fit multivariable logistic regression models, adjusting for age, sex, race/ethnicity, primary insurance, household income, patient residence, comorbidities, hospital state, and hospitalization year. We repeated the analysis for children aged 6 to 17 years. RESULTS: Among 73,408 adult patients hospitalized for acute asthma, 10.3% had OSA. Coexistent OSA was associated with a significantly higher risk of noninvasive positive pressure ventilation use (14.9% vs 3.1%; unadjusted odds ratio, 6.48; 95% CI, 5.88-7.13; adjusted odds ratio, 5.20; 95% CI, 4.65-5.80), whereas coexistent OSA was not significantly associated with the risk of invasive mechanical ventilation use. Patients with OSA had 37% longer hospital length of stay (unadjusted incidence rate ratio, 1.37; 95% CI, 1.33-1.40); this significant association persisted in the multivariable model (incidence rate ratio, 1.13; 95% CI, 1.10-1.17). The in-hospital mortality did not significantly differ between groups. These findings were consistent in both obesity and nonobesity groups and in 27,935 children. CONCLUSION: Among patients hospitalized for acute asthma, OSA was associated with a higher risk of noninvasive positive pressure ventilation use and longer length of stay compared with those without OSA.
Authors: Fatema Al-Lawati; Saif M Al-Mubaihsi; B Jayakrishnan; Sayed Rizvi; Mohammed A Al-Abri Journal: Ann Thorac Med Date: 2022-04-19 Impact factor: 2.535