Hospitalizations in OSA patients

Abstract

Obstructive sleep apnea (OSA) is associated with cardiovascular comorbidities and other chronic diseases, accounting for long-term morbidity, with elevated symptomatic burden and hospitalizations. We aim to study the hospitalizations' causes in OSA patients and its relation to OSA severity and PAP therapy adhesion.

This is a retrospective study including 281 hospitalizations corresponding to 200 OSA patients during 2019. Mean age 65 years, 67% were males, and 43,5% (n=87) had severe OSA; 85% patients under PAP; 60,4% (n=102) good adherent patients. Overlap with obesity hypoventilation syndrome (n=7) and COPD (n=48) was noticed. The main causes of hospitalization were heart failure (n=23), COPD (n=17), bariatric surgery (n=12) and stroke (n=11); mean length of stay was 8 days. About 1,5% (n=3) patients needed intensive care.

The number of hospitalizations in severe OSA were statistically higher than in non-severe OSA (1,53 vs 1,27; p<0.05). Also hospital re-admissons were higher in severe OSA (p<0,05), such as 30-day re-admissions (64%). Hospital length stay was higher in readmitted patients (9,7 vs 6,8, p<0,05). OSA severity and PAP non-adherence is related with higher hospitalization’ length (p< 0,05). Co-morbidities were associated with higher number of hospitalizations in OSA (p>0.05, 1.55 vs 1.46).

Hospitalizations are a real burden in severe OSA patients with an elevated rate of readmissions. The main causes of hospitalizations in OSA patients were congestive heart failure and COPD exacerbations conferring an additional symptomatic burden in these patients. OSA treatment should be early introduced as it seems to have a positively impact on the length of hospitalizations, especially noticed in severe OSA.