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瑞典睡眠呼吸暂停登记系统(SESAR)队列——国家级别的“真实世界数据”。

The Swedish sleep apnea registry (SESAR) cohort - "Real world data" on a national level.

作者信息

Grote Ludger, Jonzon Yvonne Asp, Barta Peter, Murto Tarmo, Nilsson Zarita, Nygren Anna, Theorell-Haglöw Jenny, Sunnergren Ola, Ulander Martin, Ekström Magnus, Palm Andreas, Hedner Jan

机构信息

Center for Sleep and Wake Disorders, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden; Pulmonary Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.

Dental Center, Skövde, Sweden.

出版信息

Sleep Med. 2024 Dec;124:362-370. doi: 10.1016/j.sleep.2024.09.039. Epub 2024 Sep 29.

Abstract

INTRODUCTION

The Swedish Sleep Apnea Registry (SESAR) collects clinical data from individual obstructive sleep apnea (OSA) patients since 2010. SESAR has recently been integrated with additional national healthcare data. The current analysis presents the SESAR structure and representative clinical data of a national sleep apnea cohort.

METHODS

Clinical data from unselected patients with a diagnosis of OSA are submitted to the SESAR registry. 48 sleep centers report data from diagnosis, treatment starts with Continuous Positive Airway Pressure (CPAP), oral devices (OD), and Upper Airway Surgery (UAS). Data from follow-up are included. SESAR is linked to mandatory national healthcare data (mortality, comorbidities, procedures, prescriptions) and diagnosis-specific quality registries (e.g. stroke, heart failure, diabetes) within the DISCOVERY project.

RESULTS

83,404 OSA patients have been reported during the diagnostic workup (age 55.4 ± 14.1 years, BMI 30.8 ± 6.5 kg/m, AHI 25.8 ± 21.6n/h, respectively). At least one cardiometabolic and respiratory comorbidity is recognized in 57 % of female and 53 % of male OSA patients with a linear increase across OSA severity. In 54,468, 7,797, and 390 patients, start of CPAP, OD or UAS treatment is reported, respectively. OD patients have 4 units lower BMI and 10 units lower AHI compared to patients started on CPAP. UAS patients are characterized by 10 years lower age. The degree of daytime sleepiness is comparable between treatment groups with mean Epworth Sleepiness Scale Scores between 9 and 10.

CONCLUSION

SESAR is introduced as a large national registry of OSA patients. SESAR provides a useful tool to highlight OSA management and to perform relevant outcome research.

摘要

引言

瑞典睡眠呼吸暂停登记处(SESAR)自2010年起收集个体阻塞性睡眠呼吸暂停(OSA)患者的临床数据。SESAR最近已与其他国家医疗保健数据整合。当前分析展示了一个全国性睡眠呼吸暂停队列的SESAR结构和代表性临床数据。

方法

诊断为OSA的未选患者的临床数据提交至SESAR登记处。48个睡眠中心报告诊断、持续气道正压通气(CPAP)治疗起始、口腔矫治器(OD)和上气道手术(UAS)的数据。随访数据也包括在内。SESAR与DISCOVERY项目中的强制性国家医疗保健数据(死亡率、合并症、手术、处方)以及特定诊断质量登记处(如中风、心力衰竭、糖尿病)相关联。

结果

在诊断检查期间报告了83404例OSA患者(年龄分别为55.4±14.1岁、体重指数30.8±6.5kg/m²、呼吸暂停低通气指数25.8±21.6次/小时)。在57%的女性和53%的男性OSA患者中至少识别出一种心血管代谢和呼吸合并症,且随着OSA严重程度呈线性增加。分别有54468例、7797例和390例患者报告了CPAP、OD或UAS治疗起始情况。与开始CPAP治疗的患者相比,使用OD的患者体重指数低4个单位,呼吸暂停低通气指数低10个单位。接受UAS治疗的患者年龄小10岁。各治疗组间日间嗜睡程度相当,平均爱泼华嗜睡量表评分为9至10分。

结论

SESAR作为一个大型的全国性OSA患者登记处被引入。SESAR为突出OSA管理及开展相关结局研究提供了一个有用的工具。

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