Department of Otolaryngology-Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan.
College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
Int J Environ Res Public Health. 2021 Mar 19;18(6):3191. doi: 10.3390/ijerph18063191.
(1) Background: Sleep apnea may be a risk factor for deep neck infection (DNI). The objective of this study was to investigate the effects of sleep apnea on DNI. (2) Methods: In this first nationwide retrospective cohort study on the sleep apnea-DNI correlation, we obtained data from the Longitudinal Health Insurance Database 2005, a subset of the Taiwan National Health Insurance Research Database. Patients who were newly diagnosed with sleep apnea between 1997 and 2012 were identified, and patients without sleep apnea were matched at a 1:4 ratio in age, sex, socioeconomic status, and urbanization level. The primary outcome of this study was DNI occurrence. The treatment modalities for sleep apnea and the comorbidities that occurred during the study period were also analyzed. (3) Results: Our sleep apnea and comparison (non-sleep apnea) cohorts comprised 6114 and 24,456 patients, respectively. We compared the cumulative incidence of DNI between these cohorts and found a greater incidence of DNI in the sleep apnea cohort ( < 0.001). A strong sleep apnea-DNI association was found following analysis via the adjusted Cox proportional-hazards model (full model hazard ratio, 1.71; 95% confidence interval, 1.28-2.28; < 0.001). In the subgroup analysis, sleep apnea increased DNI risk in men, in those aged < 50 years, and in those without diabetes mellitus, end-stage renal disease, liver cirrhosis, autoimmune disease, obesity, tonsillectomy, or adenotonsillectomy. (4) Conclusions: Our results confirmed sleep apnea to be an independent risk factor for DNI. Physicians should be aware of the potential occurrence of DNI in patients with sleep apnea.
(1) 背景：睡眠呼吸暂停可能是深部颈部感染（DNI）的危险因素。本研究旨在探讨睡眠呼吸暂停对 DNI 的影响。(2) 方法：在这项关于睡眠呼吸暂停与 DNI 相关性的首次全国性回顾性队列研究中，我们从 1997 年至 2012 年间新诊断为睡眠呼吸暂停的 Longitudinal Health Insurance Database 2005 中获取数据，这是台湾国家健康保险研究数据库的一个子集。在年龄、性别、社会经济地位和城市化水平方面，以 1:4 的比例匹配无睡眠呼吸暂停的患者。本研究的主要结局是 DNI 的发生。还分析了睡眠呼吸暂停的治疗方式以及研究期间发生的合并症。(3) 结果：我们的睡眠呼吸暂停组和对照组（无睡眠呼吸暂停组）分别包括 6114 例和 24456 例患者。我们比较了这两个队列的 DNI 累积发生率，发现睡眠呼吸暂停组的 DNI 发生率更高（<0.001）。通过调整后的 Cox 比例风险模型分析发现，睡眠呼吸暂停与 DNI 之间存在很强的关联（全模型风险比，1.71；95%置信区间，1.28-2.28；<0.001）。在亚组分析中，睡眠呼吸暂停增加了男性、年龄<50 岁和无糖尿病、终末期肾病、肝硬化、自身免疫性疾病、肥胖、扁桃体切除术或腺样体切除术患者的 DNI 风险。(4) 结论：我们的结果证实，睡眠呼吸暂停是 DNI 的独立危险因素。医生应该意识到患有睡眠呼吸暂停的患者可能会发生 DNI。
