Pépin Jean-Louis, Bailly Sébastien, Rinder Pierre, Adler Dan, Szeftel Daniel, Malhotra Atul, Cistulli Peter A, Benjafield Adam, Lavergne Florent, Josseran Anne, Tamisier Renaud, Hornus Pierre
HP2 Laboratory, University Grenoble Alpes, Inserm, CHU Grenoble Alpes, 38043 Grenoble, France.
SEMEIA, 75010 Paris, France.
J Clin Med. 2021 Mar 1;10(5):936. doi: 10.3390/jcm10050936.
The nationwide claims data lake for sleep apnoea (ALASKA)-real-life data for understanding and increasing obstructive sleep apnea (OSA) quality of care study-investigated long-term continuous positive airway pressure (CPAP) termination rates, focusing on the contribution of comorbidities. The French national health insurance reimbursement system data for new CPAP users aged ≥18 years were analyzed. Innovative algorithms were used to determine the presence of specific comorbidities (hypertension, diabetes and chronic obstructive pulmonary disease (COPD)). Therapy termination was defined as cessation of CPAP reimbursements. A total of 480,000 patients were included (mean age 59.3 ± 13.6 years, 65.4% male). An amount of 50.7, 24.4 and 4.3% of patients, respectively, had hypertension, diabetes and COPD. Overall CPAP termination rates after 1, 2 and 3 years were 23.1, 37.1 and 47.7%, respectively. On multivariable analysis, age categories, female sex (1.09 (1.08-1.10) and COPD (1.12 (1.10-1.13)) and diabetes (1.18 (1.16-1.19)) were significantly associated with higher CPAP termination risk; patients with hypertension were more likely to continue using CPAP (hazard ratio 0.96 (95% confidence interval 0.95-0.97)). Therapy termination rates were highest in younger or older patients with ≥1 comorbidity. Comorbidities have an important influence on long-term CPAP continuation in patients with OSA.
全国睡眠呼吸暂停数据湖（ALASKA）——用于理解和提高阻塞性睡眠呼吸暂停（OSA）护理质量的真实数据研究——调查了长期持续气道正压通气（CPAP）的终止率，重点关注合并症的影响。分析了法国国家医疗保险报销系统中年龄≥18岁的新CPAP使用者的数据。使用创新算法确定特定合并症（高血压、糖尿病和慢性阻塞性肺疾病（COPD））的存在。治疗终止定义为CPAP报销停止。共纳入480,000名患者（平均年龄59.3±13.6岁，65.4%为男性）。分别有50.7%、24.4%和4.3%的患者患有高血压、糖尿病和COPD。1年、2年和3年后的总体CPAP终止率分别为23.1%、37.1%和47.7%。多变量分析显示，年龄组、女性（1.09（1.08 - 1.10））、COPD（1.12（1.10 - 1.13））和糖尿病（1.18（1.16 - 1.19））与更高的CPAP终止风险显著相关；高血压患者更有可能继续使用CPAP（风险比0.96（95%置信区间0.95 - 0.97））。在患有≥1种合并症的年轻或老年患者中，治疗终止率最高。合并症对OSA患者长期CPAP治疗的持续有重要影响。
