Department of Otolaryngology, Head and Neck Surgery, Ningde Municipal Hospital of Ningde Normal University, Ningde, Fujian, China.
Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom.
PLoS One. 2024 Apr 11;19(4):e0301646. doi: 10.1371/journal.pone.0301646. eCollection 2024.
Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is characterized by a sudden worsening of chronic obstructive pulmonary disease (COPD) symptoms, which significantly contributes to hospitalizations related to COPD symptoms. Previous research has mainly focused on the correlation between obstructive sleep apnea (OSA) and COPD. However, there were few studies that investigated the short-term mortality rate of AECOPD patients with or without OSA.
Data for our research was taken from the Medical Information Mart for Intensive Care Database IV. A total of 1332 patients were included in the study based on well-defined criteria for selection and exclusion. By analyzing the characteristics of AECOPD patients, we compared those with and without OSA.
There were 1122 AECOPD patients without OSA, 210 patients with OSA. In comparison to those without OSA, patients with OSA exhibited lower 30-day and 90-day ICU mortality with unadjusted HR, as well as lower hospital mortality with unadjusted OR. However, after adjustments were made, there were no significant associations observed between OSA and short-term mortality, including 30-day ICU mortality, 90-day ICU mortality, ICU mortality, and hospital mortality in AECOPD patients. Subgroup analysis revealed that OSA may act as a risk factor for AECOPD patients with a BMI lower than 30 kg/m2.
There is no impact on short-term survival in AECOPD patients with OSA under intensive care unit (ICU) management and nursing.
慢性阻塞性肺疾病(COPD)急性加重(AECOPD)的特征是 COPD 症状突然恶化,这显著导致与 COPD 症状相关的住院。先前的研究主要集中在阻塞性睡眠呼吸暂停(OSA)与 COPD 之间的相关性。然而,很少有研究调查有无 OSA 的 AECOPD 患者的短期死亡率。
我们的研究数据来自重症监护医学信息集市 IV 数据库。根据明确的选择和排除标准,共有 1332 名患者被纳入研究。通过分析 AECOPD 患者的特征,我们比较了有无 OSA 的患者。
有 1122 例 AECOPD 患者无 OSA,210 例患者有 OSA。与无 OSA 的患者相比,有 OSA 的患者在未调整的 HR 下,30 天和 90 天 ICU 死亡率以及未调整的 OR 下的住院死亡率均较低。然而,调整后,OSA 与 AECOPD 患者的短期死亡率之间没有显著关联,包括 30 天 ICU 死亡率、90 天 ICU 死亡率、ICU 死亡率和住院死亡率。亚组分析表明,OSA 可能是 BMI 低于 30kg/m2 的 AECOPD 患者的一个危险因素。
在 ICU 管理和护理下,有 OSA 的 AECOPD 患者的短期生存没有受到影响。