551 Outcomes of Sickle Cell Crisis in Relation to Pediatric Obstructive Sleep Apnea in the United States: A US Population cohort study

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A218-A218
Author(s):  
Palakkumar Patel ◽  
Tomas Munoz ◽  
Pranshu Adavadkar
Keyword(s):  
Mechanical Ventilation ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sickle Cell ◽  
Invasive Mechanical Ventilation ◽  
The United States ◽  
Hospitalization Cost ◽  
Obstructive Sleep ◽  
Sickle Cell Crisis ◽  
Total Hospitalization Cost

Abstract Introduction This study aimed to quantify the impact of obstructive sleep apnea (OSA) on the mortality, morbidity, and resources utilization among children admitted with Sickle cell crisis (SCC) Methods This is a retrospective analysis using the 2016 and 2017 National Inpatient Sample Database. The Inclusion Criteria was a principal Diagnosis of SSC and age <18 years. OSA, as a Secondary Diagnosis, was identified using the appropriate ICD-10 CM codes. The Primary Outcomes were Inpatient Mortality, and secondary outcomes were: In-Hospital Length of Stay(LOS), Total hospitalization Cost, Blood transfusion (BT) requirement, and a requirement for Invasive mechanical ventilation (IMV). We used Multivariate Linear/ logistic regression to adjust for confounders including age and sex. Results Out of 36,484 children with SSC included in the study, 1450 children had OSA (SCC+OSA). SSC-OSA and SSC+OSA groups did not differ in gender, household income, and hospital characteristics, but did so in age (11.3 vs 12.4; p <0.001). OSA was most common in the age group of 13–18 (54%) and lowest in 0–4 (2.4%). Compared to SSC-OSA, the SCC+OSA cohort had significantly higher odds of mortality (adjusted OR= 11.9, [95% Confidence Interval: 1.02- 138.8],p=0.04). Additionally, SSC+OSA cohort was associated with increased odds of IMV (aOR=5.24 [CI: 1.84 – 14.8], p=0.002), longer LOS (adjusted mean difference (aMD)=0.67 [CI-0.32 – 1.02], p=<0.001), and higher hospitalization Cost (aMD=2818.76 [CI-1680- 4157], p=<0.001). No difference in BT (aOR=0.94 [CI: 0.68 – 1.29], p=0.71) was noted. Conclusion This study demonstrates that the presence of OSA is associated with detrimental outcomes in SSC with higher in-hospital mortality, higher morbidity (Invasive mechanical ventilation rate), and higher resource utilization (LOS, total hospitalization cost). More attention to the screening, early diagnosis, and appropriate treatment of OSA is imperative to improve health outcomes in children with sickle cell disease. Support (if any):

scholarly journals Impact of Asthma on Inpatient Outcome of Sickle Cell Crisis: A Population-Based Study

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4842-4842
Author(s):  
Zimu Gong ◽  
Faisal Shaukat S Ali ◽  
Yu Zhao ◽  
Jessica Lee Garcia
Keyword(s):  
Mechanical Ventilation ◽  
Sickle Cell ◽  
Conflicts Of Interest ◽  
Invasive Mechanical Ventilation ◽  
The United States ◽  
Acute Chest Syndrome ◽  
Inpatient Mortality ◽  
Tissue Ischemia ◽  
Sickle Cell Crisis ◽  
The Impact

Introduction: Sickle cell disease (SCD) is one of the most common inherited hematological disorder in the United States. Sickle cell crisis is a common complication caused by excessive sickling of red blood cells, resulting in tissue ischemia. The frequency of such pain crisis, however, varies greatly among patients depending on disease control and other patient characteristics. Asthma is a common comorbidity in SCD patients which is associated with higher incidence of acute chest syndrome (ACS). However, the impact of asthma on short term outcome of acute sickle cell crisis remains unclear. Methods: We analyzed data from the National Inpatient Sample database. Data entries from year 2005 through 2014 were included. The presence of SCD, sickle cell crisis, ACS, asthma are identified using corresponding ICD codes. Data regarding demographic information, performed procedures, inpatient mortality, and length of stay are extracted and analyzed accordingly. Results: A total of 247,266 records were identified. The median age at admission was 26 years (interquartile range 18 - 37), with most patients being of African American origin (91.8%). A total of 16,828 (6.8%) patients presented with ACS, whereas 173,869 (70.3%) presented with non-ACS crisis. The remaining 56,569 (22.9%) patients were admitted for reasons other than sickle cell crisis, most commonly infection. Overall, 34,609 patients (14.0%) had asthma. Compared to patients without ACS, the incidence of asthma was significantly higher in patients with ACS (19.0% vs 13.6%, P<0.001), whereas patients with non-ACS crisis had a similar incidence of asthma compared to those without sickle cell crisis (13.7% vs 13.5%, P=0.42). Asthma patients who presented with ACS exhibited a lower inpatient mortality (0.4% vs 1.1%, P<0.001), as well as lower use of invasive mechanical ventilation (3.0% vs 4.1%, P=0.006). Similarly, in patients with non-ACS sickle cell crisis, asthma was associated with lower mortality (0.4% vs 0.2%, P<0.001), lower use of invasive mechanical ventilation (0.4% vs 0.7%, P<0.001), and lower frequency of transfusion (27.5% vs 31.9%, P<0.001). Conclusion: Our study again demonstrated the association between asthma and ACS in SCD patients. Furthermore, asthma appears to be associated with superior outcome in both patients with ACS and non-ACS sickle cell crisis. Further studies are warranted to elucidate if asthma is associated with a milder form of sickle cell crisis which may correlate with the physiologic basis of these associations. Disclosures No relevant conflicts of interest to declare.

Non-Invasive Mechanical Ventilation in Chemical Lung Veterans with Obstructive Sleep Apnea

2020 ◽  
Author(s):  
Ghasem Jalali ◽  
Fariba Rezaeetalab ◽  
Fariborz Rezaeitalab ◽  
Negar Morovatdar ◽  
Mahnaz Mozdourian ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Invasive Mechanical Ventilation ◽  
Non Invasive ◽  
Obstructive Sleep

Maternal and fetal outcomes in pregnancies with obstructive sleep apnea

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Eloise Passarella ◽  
Nicholas Czuzoj-Shulman ◽  
Haim A. Abenhaim
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Temporal Trends ◽  
Multivariate Logistic Regression Analysis ◽  
The United States ◽  
Tertiary Hospital ◽  
Elevated Risk ◽  
Obstructive Sleep ◽  
Study Interval ◽  
United States Healthcare

Abstract Objectives Obstructive sleep apnea (OSA) is linked to many health comorbidities. We aimed to ascertain if OSA correlates with a rise in poor obstetrical outcomes. Methods Employing the United States’ Healthcare Cost and Utilization Project – National Inpatient Sample, we performed our retrospective cohort study including all women who delivered between 2006 and 2015. ICD-9 codes were used to characterize women as having a diagnosis of OSA. Temporal trends in pregnancies with OSA were studied, baseline features were evaluated among gravidities in the presence and absence of OSA, and multivariate logistic regression analysis was utilized in assessing consequences of OSA on patient and newborn outcomes. Results Of a total 7,907,139 deliveries, 3,115 belonged to patients suffering from OSA, resulting in a prevalence of 39 per 100,000 deliveries. Rates rose from 10.14 to 78.12 per 100,000 deliveries during the study interval (p<0.0001). Patients diagnosed with OSA were at higher risk of having pregnancies with preeclampsia, OR 2.2 (95% CI 2.0–2.4), eclampsia, 4.1 (2.4–7.0), chorioamnionitis, 1.4 (1.2–1.8), postpartum hemorrhage, 1.4 (1.2–1.7), venous thromboembolisms, 2.7 (2.1–3.4), and to deliver by caesarean section, 2.1 (1.9–2.3). Cardiovascular and respiratory complications were also more common among these women, as was maternal death, 4.2 (2.2–8.0). Newborns of OSA patients were at elevated risk of being premature, 1.3 (1.2–1.5) and having congenital abnormalities, 2.3 (1.7–3.0). Conclusions Pregnancies with OSA were linked to an elevated risk of poor maternal and neonatal outcomes. During pregnancy, OSA patients should receive attentive follow-up care in a tertiary hospital.

scholarly journals Obstructive Sleep Apnea and Severe Maternal-Infant Morbidity/Mortality in the United States, 1998-2009

SLEEP ◽  
2014 ◽  
Vol 37 (5) ◽  
pp. 843-849 ◽  
Author(s):  
Judette M. Louis ◽  
Mulubrhan F. Mogos ◽  
Jason L. Salemi ◽  
Susan Redline ◽  
Hamisu M. Salihu
Keyword(s):  
United States ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
The United States ◽  
Obstructive Sleep ◽  
Infant Morbidity
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