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Current Respiratory Medicine Reviews

Editor-in-Chief

ISSN (Print): 1573-398X
ISSN (Online): 1875-6387

Research Article

Assessment of Mortality Risk in Elderly Persons with Obstructive Sleep Apnea Diagnosed with Pneumonia

Author(s): Charlisa D. Gibson, Eric Yudelevich, Raymond A. Jean, Pius Ochieng and Raymonde E. Jean

Volume 12, Issue 4, 2016

Page: [299 - 305] Pages: 7

DOI: 10.2174/1573398X12666161025111557

Price: $65

Abstract

Objective: Aging is associated with increased risk of obstructive sleep apnea (OSA) and treatment of OSA in elderly is of great interest but controversial. Pneumonia requiring invasive mechanical ventilation (IMV) is a leading cause of death in the elderly. The purpose of the study was to assess pneumonia-related mortality in elderly persons with OSA.

Methods: The Nationwide Inpatient Sample (NIS) was investigated for discharges with a primary or secondary diagnosis of pneumonia between 2009 and 2011. Persons with OSA, aged 65 years and older, were compared to a cohort of patients without OSA. Primary outcomes were in-hospital mortality and non-routine discharge (discharge to nursing home or skilled facility). Logistic regression models were used to assess the risk of OSA on in-hospital mortality and discharge status.

Results: In 1,768,185 hospital discharges, approximately 5% had OSA, and its prevalence was inversely proportional to age (65-74: 8.3%, 75-84: 4.8%, 85+: 1.8%). Pneumonia requiring IMV was more common in the OSA cohort (OSA: 4.3% vs. Non-OSA: 3.3% <0.0001). In-hospital mortality (OSA: 3.3% vs. Non-OSA 5.1% <0.0001) and non-routine discharges (OSA: 46.9% vs. Non-OSA: 55.4% <0.0001) were significantly lower in the OSA group.

Conclusion: OSA was associated with reduced inpatient mortality risk in pneumonia related respiratory failure in elderly subjects. Sleep apnea may confer a survival benefit in older individuals; but further research is warranted.

Keywords: Elderly, pneumonia, sleep apnea.

Graphical Abstract

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