Recognition and Treatment of Sleep-Disordered Breathing in Obese Hospitalized Patients May Improve Survival. The HoSMed Database
AffiliationUniv Arizona, Coll Med, Arizona Resp Ctr
MetadataShow full item record
PublisherELSEVIER SCIENCE INC
CitationSharma, S., Mukhtar, U., Kelly, C., Mather, P., & Quan, S. F. (2017). Recognition and treatment of sleep-disordered breathing in obese hospitalized patients may improve survival. The HoSMed Database. The American journal of medicine, 130(10), 1184-1191.
JournalAMERICAN JOURNAL OF MEDICINE
Rights© 2017 Elsevier Inc. All rights reserved.
Collection InformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at firstname.lastname@example.org.
AbstractPURPOSE: Sleep-disordered breathing is a common sleep disorder. Recent studies have shown that hospitalized obese patients have a high likelihood of unrecognized sleep-disordered breathing. However, no systematic large study has so far evaluated the outcomes of a screening program. This study provides demographic, clinical, and outcome data from a screening program at a tertiary care academic center. METHODS: Subjects were 5062 patients screened from March 2013 to July 2016. Of these, 1410 underwent in-hospital overnight high-resolution pulse oximetry and 680 underwent polysomnography post discharge. Patients placed on positive airway therapy were followed in an ambulatory setting. RESULTS: The mean age was 60.7 years (SD 15.2), and mean body mass index was 34.8 kg/m(2) (SD 8.3), with 2477 (49.0%) males. Of the 1410 high-risk patients who underwent high-resolution plethysmography (HRPO), 1092 were sleep-disordered breathing positive (oxygen desaturation index [ODI] >= 5) and 680 high-risk patients underwent polysomnography. In this latter group, 585 (87%) were found to have sleep-disordered breathing (apnea-hypopnea index [AHI] > 5). A receiver operating characteristic curve for ODI derived from HRPO plotted against AHI from polysomnography showed an area under the curve of 0.83 for an ODI of > 5. Patients who were adherent to positive airway pressure therapy in the first 3 months had improved survival over a mean follow-up of 609 days compared with those who were nonadherent (P=.01). CONCLUSION: This large database of hospitalized patients confirms a high prevalence of undetected sleep-disordered breathing. Long-term follow-up of those compliant with treatment reveals a survival benefit. (C) 2017 Elsevier Inc. All rights reserved.
Note12 month embargo; published online: 2 May 2017
VersionFinal accepted manuscript
SponsorsThomas Jefferson University Hospital Department of Medicine; ReSMed
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