Sébastien Bailly1, Louis-Marie Galerneau2, Stéphane Ruckly3, Alexandre Seiller3, Nicolas Terzi2, Carole Schwebel4, Claire Dupuis5, Renaud Tamisier6, Bernard Mourvillier5, Jean-Louis Pepin6, Jean-François Timsit5. 1. Univ. Grenoble Alpes, INSERM U1042, HP2, 38000 Grenoble, France; EFCR laboratory, Grenoble Alpes University Hospital, Grenoble, France. Electronic address: sbailly@chu-grenoble.fr. 2. Univ. Grenoble Alpes, INSERM U1042, HP2, 38000 Grenoble, France; Intensive Care Unit, Grenoble Alpes University Hospital, Grenoble, France. 3. INSERM U1137, Université Paris Diderot, Sorbonne Paris Cite, Paris, France. 4. Intensive Care Unit, Grenoble Alpes University Hospital, Grenoble, France; INSERM U1039 Radiopharmaceutiques Biocliniques, Grenoble, France. 5. INSERM U1137, Université Paris Diderot, Sorbonne Paris Cite, Paris, France; Medical and Infectious Intensive Care Unit, Bichat Claude Bernard University Hospital, AP-HP, Paris, France. 6. Univ. Grenoble Alpes, INSERM U1042, HP2, 38000 Grenoble, France; EFCR laboratory, Grenoble Alpes University Hospital, Grenoble, France.
Abstract
OBJECTIVE: Patients admitted to an intensive care unit (ICU) frequently suffer from multiple chronic diseases, including obstructive sleep apnea (OSA). Until recently OSA was not considered as a key determinant in an ICU patient's prognosis. The objective of this study was to document the impact of OSA on the prognosis of ICU patients. METHODS: Data were retrospectively collected concerning adult patients admitted to ICU at two university hospitals. In a nested study OSA status was checked using the hospital electronic medical records to identify exposed and unexposed cases. The following outcomes were considered: length of stay in the ICU, ICU mortality, in-hospital mortality, ventilator-associated pneumonia (VAP). RESULTS: Out of 5146 patients included in the study, 289 had OSA at ICU admission (5.6%). After matching, the overall impact of OSA on length of ICU stay was not significant (p = .24). In a predefined subgroup analysis, there was a significant impact of OSA on the length of ICU stay for patients with BMI over 40 kg/m2 (IRR: 1.56 [1.05; 2.32], p = .03). OSA status had no impact on ICU or hospital mortality and VAP. CONCLUSION: In general, known OSA did not increase the ICU stay except for patients with both OSA and morbid obesity.
OBJECTIVE:Patients admitted to an intensive care unit (ICU) frequently suffer from multiple chronic diseases, including obstructive sleep apnea (OSA). Until recently OSA was not considered as a key determinant in an ICU patient's prognosis. The objective of this study was to document the impact of OSA on the prognosis of ICU patients. METHODS: Data were retrospectively collected concerning adult patients admitted to ICU at two university hospitals. In a nested study OSA status was checked using the hospital electronic medical records to identify exposed and unexposed cases. The following outcomes were considered: length of stay in the ICU, ICU mortality, in-hospital mortality, ventilator-associated pneumonia (VAP). RESULTS: Out of 5146 patients included in the study, 289 had OSA at ICU admission (5.6%). After matching, the overall impact of OSA on length of ICU stay was not significant (p = .24). In a predefined subgroup analysis, there was a significant impact of OSA on the length of ICU stay for patients with BMI over 40 kg/m2 (IRR: 1.56 [1.05; 2.32], p = .03). OSA status had no impact on ICU or hospital mortality and VAP. CONCLUSION: In general, known OSA did not increase the ICU stay except for patients with both OSA and morbid obesity.