THE IMPACT OF OSA ON THE OUTCOMES OF PATIENTS ADMITTED WITH A MYOCARDIAL INFARCTION

Abstract

SESSION TITLE: Monday Abstract Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/21/2019 02:30 PM - 03:15 PM PURPOSE: While obstructive sleep apnea (OSA) is a recognized cardiovascular risk factor, there is some disagreement on how OSA affects the outcomes of patients admitted with an acute myocardial infarction (MI). There is evidence to suggest that patients with a known diagnosis of OSA have improved in-hospital outcomes when admitted with an MI. The aim of this study was to explore the impact of OSA on the length of stay, total inpatient charges and in-hospital mortality in this population of patients. METHODS: This retrospective cohort study utilized data from the Nationwide Inpatient Sample (NIS) to identify adult patients (18+ years) from 2012-2015 who had a primary or secondary (DX1 or DX2) diagnosis of MI using the International Classification of Diseases, Ninth Revision; Clinical Modification (ICD9) codes. Of these patients, we also identified those who had concomitant OSA. Hospital length of stay (LOS), total inpatient charges, inpatient mortality, and the average age at admission were assessed. ICD9 codes were also used to exclude patients with missing important clinical identifiers (age, gender, death, and race). Encounters were separated into two groups: MI without OSA and MI with OSA and compared using Chi-squared and independent t-tests. RESULTS: There were 501,345 encounters identified with a diagnosis of MI who met the inclusion criteria. Of these patients, 29,661 (5.9%) had a diagnosis of OSA. The MI+OSA group had significantly lower mortality (3.8% vs 5.8% p=0.000). However, in this group, length of stay (5.56 vs 5.03 days p=0.000) and inpatient charges ($78,818 vs $72,869 p=0.000) were significantly higher. The mean age for the OSA positive group was lower (63.32 vs 66.55 years old). CONCLUSIONS: Our data suggest that patients admitted with an MI, who have a known diagnosis of OSA, have improved in-hospital mortality. Length of stay and total inpatient charges in the OSA group, however, were increased. The OSA group was younger, which could potentially contribute to the noted mortality benefit, but causality cannot be inferred. We hope that these results contribute to the growing body of literature on the subject and promote further research on the factors that could be accountable for the observed improved mortality outcomes. CLINICAL IMPLICATIONS: These results may benefit clinical decision making in this group of patients and promote further research on the subject while strengthening the existing body of literature. DISCLOSURES: No relevant relationships by Russell Arellanes, source=Web Response No relevant relationships by Andrew Dang, source=Web Response No relevant relationships by Eugene Ismailov, source=Web Response No relevant relationships by Zak Rose-Reneau, source=Web Response No relevant relationships by Derek Schirmer, source=Web Response