scholarly journals P098 Predicting delays in or failure to initiate CPAP therapy: A retrospective cohort study

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A52-A53
Author(s):  
S Moore ◽  
B Duce ◽  
C Ellender ◽  
C Hukins
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Sleep Apnoea ◽  
Male Gender ◽  
Significant Feature ◽  
Cpap Therapy ◽  
Indigenous Status ◽  
Younger Age ◽  
Obstructive Sleep

Abstract Background Suboptimal CPAP usage is associated with negative outcomes and inefficient use of medical resources. Demographic and polysomnographic characteristics are well established predictors of poor adherence, however the literature regarding patients who fail to initiate treatment is limited. This audit aimed to identify features associated with the delayed commencement or failure to initiate CPAP therapy. Methods A single institution, retrospective cohort study was performed. The cohort comprised adults with obstructive sleep apnoea prescribed CPAP between 2017 and 2018. The demographic, clinical and polysomnographic features of this cohort were identified. Comparisons were conducted between patients who initiated therapy and those who did not, as well as between early and delayed initiators of treatment, which was defined as uptake after one month. Multiple logistic regression was performed with significance defined as a p<0.05. Results 916 patients were identified. 38.2% of patients did not uptake prescribed CPAP, with male gender (p < 0.001), younger age (p=0.007) and lower pressure (p=0.016) identified as prognostic factors. Socioeconomic disadvantage (p=0.774) and Epworth Sleepiness Scale (p=0.111) were not associated with failure to start treatment. Of the 61.8% of patients who initiated CPAP therapy, 33% exhibited a delayed start to therapy, with indigenous status a significant feature of this cohort (p=0.002). Discussion A large portion of patients displayed either delayed commencement or failure to initiate CPAP therapy. Younger age, male gender and lower prescribed pressures were identified as negative predictive factors. These characteristics, as well as delayed treatment experienced in the indigenous population, provide focus points for intervention.

scholarly journals Risk of obstructive sleep apnoea in patients with rheumatoid arthritis: a nationwide population-based retrospective cohort study

BMJ Open ◽  
2016 ◽  
Vol 6 (11) ◽  
pp. e013151 ◽  
Author(s):  
Te-Chun Shen ◽  
Liang-Wen Hang ◽  
Shinn-Jye Liang ◽  
Chien-Chung Huang ◽  
Cheng-Li Lin ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cohort Study ◽  
Obstructive Sleep Apnoea ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Population Based ◽  
Sleep Apnoea ◽  
Obstructive Sleep

scholarly journals Incidence of indications for tonsillectomy and frequency of evidence-based surgery: a 12-year retrospective cohort study of primary care electronic records

2018 ◽  
Vol 69 (678) ◽  
pp. e33-e41 ◽  
Author(s):  
Dana Šumilo ◽  
Linda Nichols ◽  
Ronan Ryan ◽  
Tom Marshall
Keyword(s):  
Cohort Study ◽  
Electronic Medical Records ◽  
Retrospective Cohort Study ◽  
Medical Records ◽  
Retrospective Cohort ◽  
Periodic Fever ◽  
Sleep Apnoea ◽  
Evidence Based ◽  
Research Database ◽  
Obstructive Sleep

BackgroundNeither the incidence of indications for childhood tonsillectomy nor the proportion of tonsillectomies that are evidence-based is known.AimTo determine the incidence of indications for tonsillectomy in UK children, and the proportion of tonsillectomies meeting evidence-based criteria.Design and settingA retrospective cohort study of electronic medical records of children aged 0–15 years registered with 739 UK general practices contributing to a research database.MethodChildren with recorded indications for tonsillectomy were identified from electronic medical records. Evidence-based indications included documented sore throats of sufficient frequency and severity (Paradise criteria); periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis syndrome (PFAPA); or tonsillar tumour. Other indications were considered non-evidence-based. The numbers of children subsequently undergoing tonsillectomy was then identified. The numbers with evidence-based and non-evidence-based indications for surgery among children who had undergone tonsillectomy were determined.ResultsThe authors included 1 630 807 children followed up for 7 200 159 person–years between 2005 and 2016. Incidence of evidence-based indications for tonsillectomy was 4.2 per 1000 person years; 13.6% (2144/15 760) underwent tonsillectomy. Incidence of childhood tonsillectomy was 2.5 per 1000 person years; 11.7% (2144/18 281) had evidence-based indications, almost all with Paradise criteria. The proportion of evidence-based tonsillectomies was unchanged over 12 years. Most childhood tonsillectomies followed non-evidence-based indications: five to six sore throats (12.4%) in 1 year, two to four sore throats (44.6%) in 1 year, sleep disordered breathing (12.3%), or obstructive sleep apnoea (3.9%).ConclusionIn the UK, few children with evidence-based indications undergo tonsillectomy and seven in eight of those who do (32 500 of 37 000 annually) are unlikely to benefit.

scholarly journals Is sleep apnoea a risk factor for Covid-19? Findings from a retrospective cohort study

2020 ◽  
Author(s):  
Thijs Feuth ◽  
Tarja Saaresranta ◽  
Antti Karlsson ◽  
Mika Valtonen ◽  
Ville Peltola ◽  
...  
Keyword(s):  
Critical Care ◽  
Risk Factor ◽  
Cohort Study ◽  
Oxygen Saturation ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Sleep Apnoea ◽  
Study Data ◽  
University Hospital ◽  
Obstructive Sleep

Background: In the early phase of the coronavirus disease-19 (Covid-19) pandemic, Southwest Finland remained relatively spared. By the 3rd of May 2020, a total of 28 patients have been admitted to the Turku University Hospital. In this paper, we explore baseline characteristics in order to identify risk for severe Covid-19 disease and critical care admission. Methods For this retrospective cohort study, data were derived from hospital records. Basic descriptive statistics were used to characterise patients, including medians, percentiles and frequencies. Differences were tested with Mann Whitney U-test and Pearson's chi-square test. Results Pre-existent obstructive sleep apnoea (OSA) was present in 29% of patients admitted in the hospital for Covid-19, none of them having severe OSA. Overall, other findings on admission were comparable with those reported elsewhere. C-reactive protein (CRP) and procalcitonin (PCT) were higher in patients who were eventually transferred to critical care in comparison to in those who were not (median CRP 187 mg/L versus 52 mg/L, p<0.005 and median PCT 0.46 versus 0.12, p=0.047). Moreover, there was a trend towards lower oxygen saturation on admission in ICU-patients (87% versus 93%, p=0.09). Discussion OSA was pre-existent in a disproportional large group of patients, which suggests that it is an important risk factor for severe Covid-19. Furthermore, we identified high CRP, PCT and possibly oxygen saturation as useful clinical measures to identify patients at risk for critical care.

scholarly journals COVID-19 patients with hypothyroidism: a retrospective cohort study from a dedicated COVID hospital of Mumbai, India

2021 ◽  
Vol 8 (4) ◽  
pp. 1752
Author(s):  
Chinmay N. Gokhale ◽  
Smita S. Chavhan ◽  
Balkrishna B. Adsul ◽  
Maharudra A. Kumbhar ◽  
Kirti V. Kinge ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Death Rate ◽  
Retrospective Cohort ◽  
Male Gender ◽  
Bivariate Analysis ◽  
Chi Square ◽  
Diabetes Group ◽  
Chi Square Test ◽  
The Common

Background: India was one of the leaders in terms of COVID-19 cases across year 2020. Hypothyroidism is one of the common morbidities that may influence prognosis of infectious diseases. However, some previously published literature had suggested that hypothyroidism may not be affecting outcomes of COVID-19 disease. Objective of this study was to analyze the outcomes of COVID-19 patients with pre-existing hypothyroidism and further suggesting determinants of worse outcomesMethods: This retrospective cohort study was carried out at one of largest Dedicated COVID-19 Hospital in Mumbai, India. Of the 16306 patients that got admitted at this hospital in year 2020, all those having hypothyroidism were included. Bivariate analysis was performed using Chi-square test and Multivariate analysis was performed using multiple logistic regression.Results: A total of 251 patients were having pre-existing hypothyroidism (1.54%). More females had hypothyroidism (73.7%) while death rate was more in males (26.3%). ICU admissions (27.5%) and death proportions (18.3%) were significantly more in hypothyroidism. Diabetes and hypertension were common concomitant Co-morbidities and odds ratios for death for diabetes group, hypertension group and diabetes+hypertension group were 4.9, 8.1 and 4.4 respectively in comparison to those having exclusive hypothyroidism.Conclusions: This study deals with an important topic of co-existing Hypothyroidism in COVID-19 patients and we can conclude that patients with Hypothyroidism must be considered to be at risk of severe outcomes. Furthermore, age, male gender and presence of concomitant Co-morbidities increase the risk of worse outcome.

Obstructive sleep apnea among survivors of combat-related traumatic injury: a retrospective cohort study

2021 ◽  
Author(s):  
Zachary A. Haynes ◽  
Ian J. Stewart ◽  
Eduard A. Poltavskiy ◽  
Aaron B. Holley ◽  
Jud C. Janak ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Cohort Study ◽  
Sleep Apnea ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Traumatic Injury ◽  
Obstructive Sleep
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