Lim Zhu Wei, Wang I-Duo, Liu Feng-Cheng, Chung Chi-Hsiang, Hu Je-Ming, Tsai Pei-Yi, Chien Wu-Chien
Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua.
Department of Internal Medicine, Tri-Service General Hospital.
Medicine (Baltimore). 2021 Feb 26;100(8):e24766. doi: 10.1097/MD.0000000000024766.
Non-apnea sleep disorder (NASD) increases the risk of motor vehicle accidents. However, systemic review of NASD and its risk for all causes of injury is lacking. The aim of the present study was to provide a detailed demographic data on NASD and all causes of injury in a 14-year follow up.Our study utilized outpatient and inpatient data from the Longitudinal Health Insurance Database between 2000 and 2013 in Taiwan. We enrolled 989,753 individuals aged ≥20 years who were diagnosed with NASD as outpatients ≥3 times or inpatients ≥1 time. We matched the study cohort with a comparison cohort by age, index date and comorbidities at a ratio of 1:4. We used Cox proportional hazards regression to analyze the association of NASD and the cause of injury.In this 14-year follow up study, patients with NASD had 12.96% increased risk of injury compared to that of the control cohort. Fall was the first place of the cause of injury with 670.26 per 105 PYs. In the stratified age group, patients aged ≧65 years had the highest risk of injury (adjusted HR= 1.381; P < .001). Kaplan-Meier analysis showed that the incidence of injury between the with- and without-NASD cohorts started from the first year and persisted until the end of the follow-up.Our study demonstrates that NASD patients were associated with higher risk of all causes of injuries, with falling being the most prevalent diagnosis. The general public should be more aware of this neglected issue of NASD.
非呼吸暂停睡眠障碍（NASD）会增加机动车事故风险。然而，目前缺乏对NASD及其导致各种损伤风险的系统性综述。本研究的目的是提供14年随访中关于NASD及各种损伤原因的详细人口统计学数据。我们的研究利用了台湾2000年至2013年纵向健康保险数据库中的门诊和住院数据。我们纳入了989753名年龄≥20岁的个体，这些个体被诊断为门诊NASD≥3次或住院NASD≥1次。我们按照1:4的比例将研究队列与对照队列按年龄、索引日期和合并症进行匹配。我们使用Cox比例风险回归分析NASD与损伤原因之间的关联。在这项14年的随访研究中，与对照队列相比，NASD患者的损伤风险增加了12.96%。跌倒在损伤原因中位居首位，每10万人年有670.26例。在分层年龄组中，年龄≥65岁的患者损伤风险最高（调整后HR = 1.381；P <.001）。Kaplan-Meier分析表明，有NASD和无NASD队列之间的损伤发生率从第一年开始，并持续到随访结束。我们的研究表明，NASD患者与各种损伤原因的较高风险相关，跌倒为最常见的诊断。公众应更加关注这个被忽视的NASD问题。
