Impact of obstructive sleep apnea on the obesity paradox in critically ill patients.

Abstract

OBJECTIVE:

Patients admitted to an intensive care unit (ICU) frequently suffer from multiple chronic diseases, including obstructive sleep apnea (OSA). Until recently OSA was not considered as a key determinant in an ICU patient's prognosis. The objective of this study was to document the impact of OSA on the prognosis of ICU patients.

METHODS:

Data were retrospectively collected concerning adult patients admitted to ICU at two university hospitals. In a nested study OSA status was checked using the hospital electronic medical records to identify exposed and unexposed cases. The following outcomes were considered: length of stay in the ICU, ICU mortality, in-hospital mortality, ventilator-associated pneumonia (VAP).

RESULTS:

Out of 5146 patients included in the study, 289 had OSA at ICU admission (5.6%). After matching, the overall impact of OSA on length of ICU stay was not significant (p = .24). In a predefined subgroup analysis, there was a significant impact of OSA on the length of ICU stay for patients with BMI over 40 kg/m2 (IRR: 1.56 [1.05; 2.32], p = .03). OSA status had no impact on ICU or hospital mortality and VAP.

CONCLUSION:

In general, known OSA did not increase the ICU stay except for patients with both OSA and morbid obesity.

• Authors: Sébastien Bailly, Louis-Marie Galerneau, Stéphane Ruckly, Alexandre Seiller, Nicolas Terzi, Carole Schwebel, Claire Dupuis, Renaud Tamisier, Bernard Mourvillier, Jean-Louis Pepin, Jean-François Timsit
• Journal: Journal of critical care (J Crit Care) Vol. 56 Pg. 120-124 (04 2020) ISSN: 1557-8615 [Electronic] United States
• PMID: 31896445 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2019. Published by Elsevier Inc.

Topics

• Adult
• Aged
• Body Mass Index
• Critical Illness (therapy)
• Female
• Hospital Mortality
• Hospitalization
• Humans
• Intensive Care Units
• Length of Stay
• Male
• Middle Aged
• Obesity, Morbid (complications, therapy)
• Pneumonia, Ventilator-Associated
• Prevalence
• Prognosis
• Retrospective Studies
• Sleep Apnea, Obstructive (complications, therapy)
• Treatment Outcome