Association of obstructive sleep apnea with severity of patients hospitalized for acute asthma.
Journal
Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology
ISSN: 1534-4436
Titre abrégé: Ann Allergy Asthma Immunol
Pays: United States
ID NLM: 9503580
Informations de publication
Date de publication:
02 2020
02 2020
Historique:
received:
18
08
2019
revised:
24
10
2019
accepted:
05
11
2019
pubmed:
18
11
2019
medline:
28
4
2020
entrez:
18
11
2019
Statut:
ppublish
Résumé
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. To investigate the association of OSA with acute asthma severity. 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. 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. 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.
Sections du résumé
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.
Identifiants
pubmed: 31734330
pii: S1081-1206(19)31382-1
doi: 10.1016/j.anai.2019.11.002
pmc: PMC7752853
mid: NIHMS1649771
pii:
doi:
Types de publication
Journal Article
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
165-170.e4Subventions
Organisme : NIAID NIH HHS
ID : R01 AI127507
Pays : United States
Organisme : AHRQ HHS
ID : R01 HS023305
Pays : United States
Informations de copyright
Copyright © 2019 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
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