Mortality of obesity hypoventilation with and without CPAP Treatment : a controlled national study

Abstract

We aimed to evaluate the mortality of obesity hypoventilation (OHS) with and without treatment with continuous positive airway pressure (CPAP). Using data from the Danish National Patient Registry patients with a diagnosis of SA ( n = 30,278) were includeUsing data from the Danish National Patient Registry 1562 patients with a diagnosis of OHS ( n = 1,562) were included. They were compared to ages-, sex- and community location-matched citizens with a ratio of 1:4 a total of 6241 control subjects, 71% were males. Morbidity, all-cause mortality adjusted for the presence of age, gender, education and co-morbidity were evaluated.d. They were compared to ages-, sex- and community location- matched citizens, ratio 1:4 (120,506 control subjects, respectively). Patients with OHS in general showed increased endocrine, metabolic, neurological and pulmonary morbidities irrespective of CPAP treatment. Cardiovascular and infectious diseases were increased among those who were non-treated but not significantly increased in CPAP treated patients. the total 10 year survival were 0.639 (0.582–0.690) in OHS versus 0.855 (0.819–0.872) in controls, Hazard Ratio = 0.29, p < 0.001. Negative predictors for lower survival were age above 60 years, low education and pre- or post- diagnostic morbidities. CPAP treatment showed no significant effect on survival. Patients with OHS present significant morbidity and mortality. Factors associated with elevated mortality were male gender, age and prior co- morbidity. In this open, non- randomized study CPAP did not show any effect on mortality neither in male or female gender but we cannot exclude that patients treated with CPAP may present higher co-morbidity. Center for Healthy Aging, Faculty of Health Sciences, University of Copenhagen.