Sex-differences in the effect of obstructive sleep apnea on patients hospitalized with pulmonary embolism and on in-hospital mortality

Javier De-Miguel-Diez,David Jimenez,Valentín Hernandez-Barrera,Marta Lopez-Herranz,Rodrigo Jiménez-García,Manuel Monreal,Ana López-De-Andrés

doi:10.1038/s41598-021-97923-y

Abstract

We determined sex differences in the prevalence of obstructive sleep apnea (OSA) among patients hospitalized with pulmonary embolism (PE) in Spain (2016–2018). We also compared outcomes according to the presence of OSA, and identified variables associated with in-hospital-mortality (IHM) after PE using the Spanish National Hospital Discharge Database. We identified 46,794 hospital admissions for PE; of these, 5.47% had OSA. OSA was more prevalent among men than women (7.57% vs. 3.65%, p < 0.001), as in the general population. Propensity score matching did not reveal differences in concomitant conditions or procedures between patients with and without OSA, except for the use of non-invasive ventilation, which was more frequent in patients with OSA. IHM was similar in patients with and without OSA (3.58% vs. 4.31% for men and 4.39% vs. 4.93% for women; p > 0.05). Older age, cancer, atrial fibrillation, non-septic shock, and need for mechanical ventilation increased IHM in men and women with OSA hospitalized with PE. The logistic regression model showed no sex differences in IHM among patients with OSA.

Highlights

obstructive sleep apnea (OSA) seems to increase the risk of pulmonary embolism (PE) and or r ecurrences[13], yet data on the association between OSA and prognosis of PE patients are contradictory
The objectives of this study were as follows: (a) to determine sex differences in the prevalence of OSA among patients hospitalized with PE; (b) to determine and compare clinical characteristics, use of therapeutic procedures, and in hospital mortality (IHM) among men and women with PE according to the presence of OSA; and (c) to identify which variables are independently associated with IHM after PE in men and women with OSA
The prevalence of OSA rose in line with the number of comorbidities included in the Charlson comorbidity index (CCI) from 4.36% among patients with CCI 0–8.03% in those with CCI > 2 (p < 0.001)

Summary

Introduction

OSA seems to increase the risk of PE and or r ecurrences[13], yet data on the association between OSA and prognosis of PE patients are contradictory. Some authors found no association between OSA and 30-day mortality in PE p atients[14], whereas others have suggested that OSA is a predictor of PE-related death[15]. The objectives of this study were as follows: (a) to determine sex differences in the prevalence of OSA among patients hospitalized with PE; (b) to determine and compare clinical characteristics, use of therapeutic procedures, and in hospital mortality (IHM) among men and women with PE according to the presence of OSA; and (c) to identify which variables are independently associated with IHM after PE in men and women with OSA

Objectives

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Results

Conclusion