Univ. Grenoble Alpes, INSERM U1042, HP2, 38000 Grenoble, France; EFCR laboratory, Grenoble Alpes University Hospital, Grenoble, France.
Univ. Grenoble Alpes, INSERM U1042, HP2, 38000 Grenoble, France; Intensive Care Unit, Grenoble Alpes University Hospital, Grenoble, France.
J Crit Care. 2020 Apr;56:120-124. doi: 10.1016/j.jcrc.2019.12.016. Epub 2019 Dec 20.
Patients admitted to an intensive care unit (ICU) frequently suffer from multiple chronic diseases, including obstructive sleep apnea (OSA). Until recently OSA was not considered as a key determinant in an ICU patient's prognosis. The objective of this study was to document the impact of OSA on the prognosis of ICU patients.
Data were retrospectively collected concerning adult patients admitted to ICU at two university hospitals. In a nested study OSA status was checked using the hospital electronic medical records to identify exposed and unexposed cases. The following outcomes were considered: length of stay in the ICU, ICU mortality, in-hospital mortality, ventilator-associated pneumonia (VAP).
Out of 5146 patients included in the study, 289 had OSA at ICU admission (5.6%). After matching, the overall impact of OSA on length of ICU stay was not significant (p = .24). In a predefined subgroup analysis, there was a significant impact of OSA on the length of ICU stay for patients with BMI over 40 kg/m (IRR: 1.56 [1.05; 2.32], p = .03). OSA status had no impact on ICU or hospital mortality and VAP.
In general, known OSA did not increase the ICU stay except for patients with both OSA and morbid obesity.
入住重症监护病房（ICU）的患者常患有多种慢性病，包括阻塞性睡眠呼吸暂停（OSA）。直到最近，OSA 才被认为是 ICU 患者预后的关键决定因素。本研究的目的是记录 OSA 对 ICU 患者预后的影响。
回顾性收集了两所大学医院 ICU 收治的成年患者的数据。在一项嵌套研究中，使用医院电子病历检查 OSA 状况，以确定暴露和未暴露病例。考虑了以下结果：ICU 住院时间、ICU 死亡率、院内死亡率、呼吸机相关性肺炎（VAP）。
在纳入研究的 5146 名患者中，289 名患者在 ICU 入院时患有 OSA（5.6%）。匹配后，OSA 对 ICU 住院时间的总体影响不显著（p=0.24）。在预先定义的亚组分析中，对于 BMI 超过 40kg/m2 的患者，OSA 对 ICU 住院时间的影响具有显著意义（IRR：1.56[1.05；2.32]，p=0.03）。OSA 状况对 ICU 或医院死亡率和 VAP 没有影响。
一般来说，已知的 OSA 不会增加 ICU 住院时间，但对于同时患有 OSA 和病态肥胖的患者除外。
