Outcomes of patients hospitalized for acute pulmonary embolism by obstructive sleep apnea status

Joshi, Aditya; Hajjali, Raef; Gokhale, Avantee; Smith, T. H.; Dey, Amit; Dahiya, Garima; Lerman, Joseph B; Sajja, Aparna; Kanwar, Manreet; Raina, Amresh

doi:10.1177/2045894021996224

Cited by 6 publications

(10 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As might be expected, NIV was more common in men and women with OSA than in those without OSA, possibly because the former may have had more severe PE or hypoxemia 26 . Nevertheless, NIV was not a predictor of IHM in OSA patients admitted with PE.…”

Section: Discussionsupporting

confidence: 64%

“…The potential resulting protective effect could be associated with lower mortality. This explanation could justify the findings of Joshi et al 26 , who reported prevalent OSA to be associated with lower IHM in PE patients. The same authors also suggested that OSA could lead to increased hemoglobin levels resulting from hypoxemia, which may confer a protective effect in acute PE by preventing hypoxia from worsening 14 , 26 .…”

Section: Discussionsupporting

confidence: 54%

See 1 more Smart Citation

Sex-differences in the effect of obstructive sleep apnea on patients hospitalized with pulmonary embolism and on in-hospital mortality

de-Miguel-Díez

López-Herránz

Hernández‐Barrera

et al. 2021

Sci Rep

View full text Add to dashboard Cite

We determined sex differences in the prevalence of obstructive sleep apnea (OSA) among patients hospitalized with pulmonary embolism (PE) in Spain (2016–2018). We also compared outcomes according to the presence of OSA, and identified variables associated with in-hospital-mortality (IHM) after PE using the Spanish National Hospital Discharge Database. We identified 46,794 hospital admissions for PE; of these, 5.47% had OSA. OSA was more prevalent among men than women (7.57% vs. 3.65%, p < 0.001), as in the general population. Propensity score matching did not reveal differences in concomitant conditions or procedures between patients with and without OSA, except for the use of non-invasive ventilation, which was more frequent in patients with OSA. IHM was similar in patients with and without OSA (3.58% vs. 4.31% for men and 4.39% vs. 4.93% for women; p > 0.05). Older age, cancer, atrial fibrillation, non-septic shock, and need for mechanical ventilation increased IHM in men and women with OSA hospitalized with PE. The logistic regression model showed no sex differences in IHM among patients with OSA.

show abstract

Section: Discussionsupporting

confidence: 64%

Section: Discussionsupporting

confidence: 54%

Sex-differences in the effect of obstructive sleep apnea on patients hospitalized with pulmonary embolism and on in-hospital mortality

de-Miguel-Díez

López-Herránz

Hernández‐Barrera

et al. 2021

Sci Rep

View full text Add to dashboard Cite

show abstract

“…These findings were confirmed independently in a more recent study [ 35 ]. Similarly, other recent publications involving patients hospitalized for myocardial infarction [ 25 , 27 ], pulmonary embolism [ 29 ] and critically ill patients [ 36 ], showed a decrease of in-hospital mortality associated with diagnosed SA. The mechanisms underlying these findings are incompletely understood.…”

Section: Discussionsupporting

confidence: 57%

“…The outcome of hospitalized patients with SA has only been scarcely investigated and is still controversial [ 24 , 25 ]. Patients with SA typically have a greater burden of comordities, use more hospital resources [ 26 ] but, for certain conditions (including myocardial infarction, pneumonia, pulmonary embolism), have a lower inpatient mortality [ 25 , 27 – 29 ].…”

Section: Introductionmentioning

confidence: 99%

In-hospital survival paradox in patients with sleep apnea—A nation-wide nested case-control study

Moser

Baty²,

Brutsche³

et al. 2022

PLoS ONE

View full text Add to dashboard Cite

Background Sleep apnea (SA) is a prevalent disorder characterized by recurrent events of nocturnal apnea originating from obstructive and/or central mechanisms. SA disrupts normal sleep and can lead to a series of complications when left untreated. SA results in intermittent hypoxia which has an impact on the cardio- and cerebrovascular system. Hospitalized patients with SA typically have a greater burden of comorbidity, a longer length of hospital stay, but may show an improvement of in-hospital mortality compared to patients without diagnosed SA. The reason for this survival benefit is controversial and we aimed to clarify this protective effect in the light of predictive factors including SA-associated comorbidities using a nation-wide hospitalization database. Methods and findings Data were extracted from a nation-wide hospitalization database provided by the Swiss Federal Office for Statistics. Hospitalized patients with a SA co-diagnosis were extracted from the database together with a 1:1-matched control population without SA. Overall, 212’581 patients with SA were hospitalized in Switzerland between 2002 and 2018. Compared to the controls, SA cases had a longer median length of hospital stay (7 days; 95% CI: 3 to 15 vs. 4 days; 95% CI: 2 to 10) (p < 0.001) and a higher median number of comorbidities (8 comorbidities; IQR: 5 to 11 vs. 3 comorbidities; IQR: 1 to 6) (p < 0.001). The risk of in-hospital mortality was lower in the SA cases compared to the controls (OR: 0.73; 95% CI: 0.7 to 0.76; p < 0.001). SA was associated with a survival benefit in hospitalizations related to 28 of 47 conditions with the highest rate of in-hospital death. Sixty-three comorbidities were significantly over-represented in SA cases among which obesity, hypertension and anatomic nasal deviations were associated with a significant decrease of in-hospital mortality. Conclusions Compared to matched controls, SA was associated with significant and relevant inpatient survival benefit in a number of most deadly conditions. Within SA-patients, associated comorbidities mostly correlated with a poorer prognosis, whereas obesity and hypertension were associated with an improved in-hospital mortality.

show abstract

“…After evaluation of full-texts 11 were excluded as they did not satisfy the inclusion criteria. Finally, 12 studies were included in the present review (8)(9)(10)(14)(15)(16)(17)(18)(19)(20)(21)(22).…”

Section: Resultsmentioning

confidence: 99%

Impact of obstructive sleep apnea on outcomes of pulmonary embolism: A systematic review and meta‑analysis

Zhang

Ding

2023

Exp Ther Med

View full text Add to dashboard Cite

The current review aimed to assess the effect of obstructive sleep apnea (OSA) on the severity and outcomes of pulmonary embolism (PE). PubMed, Embase, ScienceDirect, CENTRAL and Google Scholar were searched for studies assessing the impact of OSA on severity and outcomes of PE. A total of 12 studies were included. Meta-analysis revealed that simplified PE severity index of >1 and pulmonary artery obstruction index score was significantly higher in patients with OSA as compared with controls, but there was no difference in right ventricle to left ventricle short-axis diameter. The need for non-invasive ventilation was significantly higher in patients with OSA but there was no difference in the need for mechanical ventilation. Patients with OSA had a significantly higher incidence of recurrence of PE. Meta-analysis also showed a statistically significantly lower risk of in-hospital mortality in patients with OSA as compared with controls, but without any difference in the risk of late mortality. Adjusted data on mortality indicated a significantly lower risk of mortality in PE patients with comorbid OSA. Limited data shows that comorbid OSA increases the severity of PE but has no effect on right ventricular function. OSA may increase the risk of recurrent PE. Paradoxically, the presence of OSA may also reduce the risk of in-hospital mortality. Results must be interpreted with caution owing to high inter-study heterogeneity and lack of matching of baseline characteristics. Current evidence needs to be confirmed by high-quality prospective studies.

show abstract

Outcomes of patients hospitalized for acute pulmonary embolism by obstructive sleep apnea status

Cited by 6 publications

References 29 publications

Sex-differences in the effect of obstructive sleep apnea on patients hospitalized with pulmonary embolism and on in-hospital mortality

Sex-differences in the effect of obstructive sleep apnea on patients hospitalized with pulmonary embolism and on in-hospital mortality

In-hospital survival paradox in patients with sleep apnea—A nation-wide nested case-control study

Impact of obstructive sleep apnea on outcomes of pulmonary embolism: A systematic review and meta‑analysis

Contact Info

Product

Resources

About