Acute pulmonary embolism in patientswith obstructive sleep apnea: Frequency, hospital outcomes, and recurrence

Zeynep Idil Seckin, Haytham Helmi, Timothy J. Weister, Augustine S Lee, Emir Festic

Research output: Contribution to journalArticle

Abstract

Study Objectives: The objectives of this study were to assess the effect of obstructive sleep apnea (OSA) on the risk of acute pulmonary embolism (PE), hospital outcomes including mortality, and PE recurrence. Methods: We retrospectively enrolled adult patients, admitted to Mayo Clinic Hospital in Rochester, Minnesota, within a 5-year period (2009-2013). We compared frequency of PE, hospital mortality, and secondary outcomes in patients with OSA versus patients without OSA. We assessed risk of PE recurrence in relation to compliance with OSA therapy. Results: Of 25,038 patients, 3,184 (13%) had OSA and 283 (1.1%) experienced PE. Frequency of PE in patients with and without OSA was 2.4% versus 0.9% (odds ratio [OR], 2.51; 95% confidence interval [CI], 1.9-3.3; P < .001). OSA was independently associated with increased risk of PE after adjusting for demographics and comorbidities (OR, 1.44; 95%CI, 1.07-1.9; P =.017). Adjusted hospital mortality was increased in patients with PE (OR, 2.88; 95% CI, 1.7-4.9; P <.001) but not in patients with OSA (OR, 0.98; 95% CI, 0.7-1.4, P =.92). OSA was not a significant determining factor for mortality in patients who experienced a PE (OR, 0.56; 95% CI, 0.1.1-2.78; P =.47), adjusting for demographics, PE severity, and Charlson comorbidity index. Adjusted risk of PE recurrence was greater in patients with OSA compared with patients without OSA (OR, 2.21; 95% CI, 1.05-4.68; P < .04). The patients compliant with OSA therapy had a lower rate of PE recurrence (16% vs 32%; P = not significant). Conclusions: Although OSA significantly increases risk of acute PE occurrence and recurrences, related hospital mortality was not greater in patients with OSA compared with those without OSA. OSA therapy might have a modifying effect on PE recurrence.

Original languageEnglish (US)
Pages (from-to)1029-1036
Number of pages8
JournalJournal of Clinical Sleep Medicine
Volume16
Issue number7
DOIs
StatePublished - Jul 15 2020

Keywords

  • Acute pulmonary embolism
  • Hospital mortality
  • Obstructive sleep apnea
  • Recurrent pulmonary embolism

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Neurology
  • Clinical Neurology

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