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睡眠呼吸暂停综合征作为老年住院患者死亡的一个风险因素。

Sleep apnoea syndrome as a risk for mortality in elderly inpatients.

作者信息

Morimoto S, Takahashi T, Okaishi K, Okuro M, Nakahashi T, Sakamoto D, Mizuno T, Kanda T, Takahashi M, Toga H

机构信息

Department of Geriatric Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa 920-0293, Japan.

出版信息

J Int Med Res. 2012;40(2):601-11. doi: 10.1177/147323001204000222.

Abstract

OBJECTIVE

The characteristics of sleep apnoea syndrome (SAS) in the elderly, including subtype classification and association with mortality, have not been fully elucidated. This study examined these factors in an elderly Japanese inpatient population.

METHODS

Overnight polysomnography was used to diagnose and classify SAS in 145 elderly inpatients (mean ± age 81 ± 8 years). Clinical data, including brain computerized tomography findings, were recorded. The study population included nine inpatients with obstructive SAS, 12 with central SAS, 25 with mixed SAS and 99 controls (no SAS).

RESULTS

Increased body mass index and grade of aortic arch calcification independently contributed to risk of all subtypes of SAS combined. There was an independent association between SAS and increased risk of mortality from all causes as well as from pneumonia and from cardiovascular disease. Only mixed SAS was independently and positively associated with increased risk of death from pneumonia.

CONCLUSIONS

Obstructive, central and mixed SAS were associated with increased risk of cardiovascular related and all-cause mortality. Mixed SAS was associated with an increase in mortality from pneumonia. There was no relationship between mortality and severity of SAS.

摘要

目的

老年人睡眠呼吸暂停综合征(SAS)的特征,包括亚型分类及其与死亡率的关联,尚未完全阐明。本研究在日本老年住院患者中对这些因素进行了调查。

方法

采用夜间多导睡眠图对145例老年住院患者(平均年龄81±8岁)进行SAS的诊断和分类。记录临床数据,包括脑部计算机断层扫描结果。研究人群包括9例阻塞性SAS住院患者、12例中枢性SAS患者、25例混合性SAS患者和99例对照者(无SAS)。

结果

体重指数增加和主动脉弓钙化分级独立导致所有SAS亚型合并风险增加。SAS与全因死亡率以及肺炎和心血管疾病导致的死亡风险增加之间存在独立关联。仅混合性SAS与肺炎导致的死亡风险增加独立且呈正相关。

结论

阻塞性、中枢性和混合性SAS与心血管相关死亡率和全因死亡率增加有关。混合性SAS与肺炎死亡率增加有关。死亡率与SAS严重程度之间无关联。

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