Medical Care Line, Section of Pulmonary, Critical Care and Sleep Medicine, Michael E. DeBakey VA Medical Center, Houston, TX, USA; Department of Medicine, Section of Pulmonary, Critical Care and Sleep Medicine, Baylor College of Medicine, Houston, TX, USA.
Elula AI, Sydney, Australia.
Sleep Med. 2021 May;81:294-299. doi: 10.1016/j.sleep.2021.02.044. Epub 2021 Feb 26.
Obstructive sleep apnea is prevalent among those undergoing elective surgery and likely introduces a risk of adverse outcomes. To understand its impact, we aimed to compare healthcare utilization in postsurgical patients with obstructive sleep apnea compared to controls matched on the surgical care environment.
This is a retrospective case-control cohort study using a nationwide database. Among patients undergoing elective surgical procedures during 2009-2014, we compared patients with obstructive sleep apnea with those without obstructive sleep apnea. The two cohorts were matched based on age, sex, type of surgery, performing surgeon, the hospital where the procedure was performed, and various All-Patient-Refined Diagnosis-Related-Groups severity indices. The primary effect of interest was short-term healthcare utilization. We also compared long-term hospital admissions, intensive care unit admissions, emergency room visits and outpatient visits.
47,719 subjects and controls were matched on a 1:1 basis. As the subjects were matched, the two groups did not differ on age, percent female, and various Diagnosis-Related-Groups severity indices. The obstructive sleep apnea group had more comorbid conditions and a higher Elixhauser index. Short-term healthcare utilization measured by the length of stay and mortality related to index procedure did not increase in the sleep apnea group. In hierarchical logistical regression analysis, the presence of sleep apnea predicted higher long-term health care utilization.
Our data suggests that the presence of sleep apnea was not associated with increased post elective surgical length of stay and mortality; however, the presence of obstructive sleep apnea was associated with long-term health care utilization.
阻塞性睡眠呼吸暂停在接受择期手术的患者中较为常见，可能会增加不良结局的风险。为了了解其影响，我们旨在比较患有阻塞性睡眠呼吸暂停的术后患者与在手术环境方面相匹配的对照组的医疗保健利用情况。
这是一项使用全国性数据库的回顾性病例对照队列研究。在 2009 年至 2014 年期间接受择期手术的患者中，我们比较了患有阻塞性睡眠呼吸暂停的患者与没有阻塞性睡眠呼吸暂停的患者。这两个队列是基于年龄、性别、手术类型、手术医生、手术医院以及各种全患者精细化诊断相关组严重程度指数进行匹配的。主要感兴趣的效果是短期医疗保健利用情况。我们还比较了长期住院、重症监护病房入院、急诊就诊和门诊就诊情况。
47719 名患者和对照组进行了 1:1 匹配。由于患者进行了匹配，两组在年龄、女性比例和各种诊断相关组严重程度指数方面没有差异。阻塞性睡眠呼吸暂停组有更多的合并症和更高的 Elixhauser 指数。以住院时间和与指数手术相关的死亡率衡量的短期医疗保健利用率在睡眠呼吸暂停组并没有增加。在分层逻辑回归分析中，睡眠呼吸暂停的存在预测了更高的长期医疗保健利用。
我们的数据表明，阻塞性睡眠呼吸暂停的存在与择期手术后住院时间和死亡率的增加无关；然而，阻塞性睡眠呼吸暂停的存在与长期医疗保健利用有关。
