Obstructive sleep apnea and adverse outcomes in surgical and nonsurgical patients on the wards
Open accessAbstract
BACKGROUND: Obstructive sleep apnea (OSA) has been associated with clinical deterioration in postoperative patients and patients hospitalized with pneumonia. Paradoxically, OSA has also been associated with decreased risk of inpatient mortality in these same populations. OBJECTIVES: To investigate the association between OSA and in‐hospital mortality in a large cohort of surgical and nonsurgical ward patients. DESIGN: Observational cohort study. SETTING: A 500‐bed academic tertiary care hospital in the United States. PATIENTS: A total of 93,676 ward admissions from 53,150 unique adult patients between November 1, 2008 and October 1, 2013. INTERVENTION: None. MEASUREMENTS: OSA diagnoses and comorbidities were identified by International Classification of Diseases, Ninth Revision, Clinical Modification codes. Logistic regression was used to control for patient characteristics, location prior to ward admission, and admission severity of illness. The primary outcome was in‐hospital death. Secondary outcomes included rapid response team (RRT) activation, intensive care unit (ICU) transfer, intubation, and cardiac arrest on the wards. MAIN RESULTS: OSA was identified in 5,625 (10.6%) patients. Patients with OSA were more likely to be older, male, and obese, and had higher rates of comorbidities. OSA patients had more frequent RRT activations (1.5% vs 1.1%) and ICU transfers (8% vs 7%) than controls (P < 0.001 for both comparisons), but a lower inpatient mortality rate (1.1% vs 1.4%, P < 0.05). OSA was associated with decreased adjusted odds for ICU transfer (odds ratio [OR]: 0.91 [0.84‐0.99]), cardiac arrest (OR: 0.72 [0.55‐0.95]), and in‐hospital mortality (OR: 0.70 [0.58‐0.85]). CONCLUSIONS: After adjustment for important confounders, OSA was not associated with clinical deterioration on the wards and was associated with significantly decreased in‐hospital mortality. Journal of Hospital Medicine 2015;10:592–598. © 2015 Society of Hospital Medicine
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Data about postoperative mortality is mixed but generally shows no increased 30-day mortality, thought to be due to increased monitoring.
“Data about postoperative mortality is mixed but generally shows no increased 30-day mortality, which is thought to be due to increased monitoring in this group of patients.”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [482]
The Results (Subgroup Analyses) report lower adjusted odds of in-hospital death among surgical patients with OSA, and the Discussion suggests more vigilant care as one possible explanation. The study did not measure 30-day mortality, however, and the Discussion says systematic early recognition through monitoring was unlikely in its own cohort. It therefore does not establish increased monitoring as the explanation. (LLM, conf=0.87)
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References 43 · Cited by 25
- Authors
- Lyons, P. G., Zadravecz, F. J., Edelson, D. P., Mokhlesi, B., & Churpek, M. M.
- Affiliations
- University of Chicago (US)
- Corresponding author
- Churpek, Matthew M.
- Venue
- Journal of Hospital Medicine
- Publisher
- Wiley
- Published
- 2015-06-13
- Volume
- 10
- Issue
- 9
- Pages
- 592-598
- ISSN
- 1553-5592 (ISSN-L)
- 1553-5606
- PMC
- PMC4560995
- OpenAlex
- W1517199494
- Cited by
- 25
- References
- 43
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 3 · 2022: 2 · 2021: 4 · 2020: 2 · 2019: 1 · 2018: 3 · 2017: 1 · 2016: 5 · 2015: 1
- FWCI
- 2.46
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Hospital Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- American Heart Association
- National Institutes of Health
- National Heart, Lung, and Blood Institute (K08HL121080, R01HL119161, K23HL097157)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Keywords
- obstructive sleep apnea, in-hospital mortality, ward patients, surgical patients, non-surgical patients, rapid response team activation, ICU transfer, cardiac arrest, intubation, clinical deterioration
- MeSH terms
- Academic Medical Centers, Adult, Aged, Female, Heart Arrest, Humans, Intensive Care Units, Male, Middle Aged, Patient Transfer, United States, Cohort Studies, Hospital Mortality, Sleep Apnea, Obstructive, Hospital Rapid Response Team
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