Abstract 17982: Impact of Obstructive Sleep Apnea on Bradyarrhythmia Hospitalizations: Analysis of the National Inpatient Sample 2016-2020

Abstract

Background: Obstructive sleep apnea (OSA) has been associated with many forms of heart rhythm disorders, including bradycardia and cardiac conduction delay. Here, we aimed to investigate the relationship between OSA and bradyarrhythmias. Methods: A retrospective cohort study was conducted using the Nationwide Inpatient Sample from 2016 to 2020. 1,685,704 hospitalizations with a primary diagnosis of bradyarrhythmias (including sinus node dysfunction, atrioventricular block and cardiac conduction disorder with 1:1 AV conduction) were identified and stratified based on the presence of OSA using ICD-10 codes. Multivariate regression analysis was used to adjust for confounders and analyze the variables. Results: Out of the 1,685,704 hospitalizations with bradyarrhythmias, 204,307 (%12.1) had OSA. In-hospital mortality in patients with OSA was significantly lower (3.51% vs 5.64%; p<0.001). When adjusted to patient demographics, comorbidities, and hospital characteristics, independent risk factors for inpatient mortality included congestive heart failure (aOR 1.22, 95% CI 1.17 - 1.27, p-value<0.001), atrial fibrillation (aOR 1.14, 95% CI 1.10 - 1.18, p-value <0.001); however conditions associated with a lower risk for inpatient mortality included previous CABG (aOR 0.91, 95% CI 0.85 - 0.97, p-value 0.004) and previous pacemaker (aOR 0.61, 95% CI 0.58 - 0.65, p-value <0.001). Mean length of stay (LOS) and mean hospital charges (HC) were also lower in the presence of obstructive sleep apnea compared to those without (5.28 vs 6.01 days, p-value 0.002 & $90,549 vs $103,450, p-value < 0.001 respectively). Conclusion: Amongst hospitalizations with a primary diagnosis of bradyarrhythmias, patients with OSA had better outcomes in terms of in-hospital mortality, length of stay and total mean hospitalization charges. This likely suggests that OSA-related bradyarrhythmias are a more benign and modifiable when compared to non-OSA-related bradyarrhythmias.