Which Comorbidities Predict Mortality in OSA?

The prevalence of obstructive sleep apnea (OSA) is on the rise. This increase showcases the need to understand the disease and the health risks that come along with it. A study presented at the CHEST Annual Meeting 2020 evaluated the association between mortality and pulmonary and cardiovascular comorbidities in OSA inpatients.

The researchers collected data from the National Inpatient Sample database spanning 2010 through 2014 on hospitalizations for OSA. They performed univariate and multivariate logistic regression analyses, adjusting for age, sex, race, and selected respiratory and cardiac comorbidities in the latter analysis.

A total of 7,542,841 hospital admissions for patients with OSA were identified during the study period. The mean patient age was 60.4 years, and 44% of patients were female. The mortality rate was 1.2%. Most patients with poor outcomes (84.1%) were aged 40 to 80 years. Comorbidities observed in the patient population that were tested included heart failure (26.1%), atrial fibrillation (19.1%), asthma (15.0%), bronchitis (11.0%), and interstitial lung disease (ILD) (2.1%),

Multivariate analysis unearthed an association between mortality and concomitant ILD (odds ratio [OR], 1.088; 95% confidence interval [CI], 1.037-1.140), bacterial pneumonia (OR, 6.231; 95% CI, 6.103-6.361), pulmonary embolism (OR, 2.550; 95% CI, 2.468-2.635), and heart failure (OR, 1.620; 95% CI, 1.596-1.643). Asthma (OR, 0.564; 95% CI, 0.549-0.579) and bronchitis (OR, 0.910; 95% CI, 0.892-0.929) did not increase mortality risk; the researchers theorized, “This may be because OSA, asthma, and bronchitis involve airway obstruction and can be relieved with the help of bronchodilators and positive air pressure ventilation.”

“Our findings add to the growing evidence that OSA represents a major risk factor for mortality in hospitalized patients,” they concluded.