Jennum Poul, Rejkjær-Knudsen Mathias, Ibsen Rikke, Kiær Eva Kirkegaard, von Buchwald Christian, Kjellberg Jakob
Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Sleep Med. 2020 Nov;75:441-447. doi: 10.1016/j.sleep.2020.08.017. Epub 2020 Aug 24.
There is limited information about the long-term outcome of obstructive sleep apnea (OSA) diagnosed in children and adolescents for educational and social factors. Here, we estimate the long-term socioeconomic outcome and health care costs of OSA.
The historical case-control cohort study included Danish individuals with OSA diagnosed in childhood or adolescence between 1994 and 2015. Health care costs and socioeconomic data were obtained from nationwide administrative and health registers. A total of 5419 were diagnosed during this period; of these we traced 1004 patients who we compared with 4085 controls (mean index age, 10.2 years; Standard Deviation (SD), 5.6 years) until the age of 20 years. Controls were matched for age, gender, and residency.
Comparing the OSA patient and control groups at age 20 years we found: 1) lower parental educational level; 2) significantly lower educational level also after adjustment for parental educational level; 3) lower school grade-point averages; 4) lower employment rate and lower income, which was not fully compensated when transfer payments were considered; and 5) patients' initial health care costs were higher due to higher morbidity. Patients showed higher mortality rates than controls (Hazard Ratio (HR) = 7.63, 95% CI = 4.87-11.95, P < 0.001).
OSA in children and adolescent is associated with a significant influence on morbidity, mortality, educational level, grading, social outcome, and welfare consequences.
由于教育和社会因素，关于儿童和青少年阻塞性睡眠呼吸暂停（OSA）的长期预后的信息有限。在此，我们估计OSA的长期社会经济后果和医疗保健成本。
这项历史性病例对照队列研究纳入了1994年至2015年间在儿童期或青少年期被诊断为OSA的丹麦个体。医疗保健成本和社会经济数据来自全国性行政和健康登记处。在此期间共诊断出5419例；其中，我们追踪了1004例患者，并将其与4085名对照者（平均指数年龄10.2岁；标准差（SD）5.6岁）进行比较，直至20岁。对照者按年龄、性别和居住地进行匹配。
在20岁时比较OSA患者组和对照组，我们发现：1）父母教育水平较低；2）在调整父母教育水平后，教育水平也显著较低；3）学校平均绩点较低；4）就业率和收入较低，在考虑转移支付时，收入并未得到充分补偿；5）由于发病率较高，患者的初始医疗保健成本较高。患者的死亡率高于对照组（风险比（HR）=7.63，95%置信区间=4.87-11.95，P<0.001）。
儿童和青少年OSA对发病率、死亡率、教育水平、成绩、社会结局和福利后果有重大影响。
