OSA Treatment on Cardio‐ and Cerebrovascular Comorbidities: A Long‐term Nationwide Cohort Study. (14th December 2021)

• Record Type: Journal Article
• Authors: Yang, Kun‐Lin; Lin, Pei‐Wen; Chang, Chun‐Tuan; Liu, Pi‐Hua; Lin, Hsin‐Ching; Friedman, Michael; Salapatas, Anna M.
• Is Part Of: Otolaryngology--head and neck surgery. Volume 167:Number 3(2022)
• Page Start: 600
• Page End: 606
• Publication Date: 2021-12-14
• Subjects: obstructive sleep apnea -- myocardial infarction -- stroke; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/01945998211065656
• Languages: English
• ISSNs: 0194-5998

Abstract

Abstract : Objective: To compare the cardio‐ and cerebrovascular outcomes and survival rates of surgical and nonsurgical interventions for patients with obstructive sleep apnea (OSA) based on a national population‐based database. Study Design: Retrospective cohort study. Setting: Taiwan National Health Insurance Research Database. Methods: We analyzed all cases of OSA among adults (age >20 years and confirmed with ICD‐9‐CM ) from January 2001 to December 2013. We compared the patients with OSA who received upper airway surgery with age‐, sex‐, and comorbidity index–matched controls with continuous positive airway pressure (CPAP) treatment. The risk of myocardial infarction (MI) or stroke after treatment of OSA‐related surgery versus CPAP was investigated. Results: During follow‐up, 112 and 92 incident cases of MI occurred in the OSA surgery and CPAP treatment groups, respectively (rates of 327 and 298 per 100, 000 person‐years). Furthermore, 50 and 39 cases were newly diagnosed with stroke in the OSA surgery and CPAP treatment groups (rates of 144 and 125 per 100, 000 person‐years). Cox proportional hazard regressions showed that the OSA treatment groups (OSA surgery vs CPAP) were not significantly related to MI (hazard ratio, 1.03 [95% CI, 0.781‐1.359]; P =. 833) and stroke (hazard ratio, 1.12 [95% CI, 0.736‐1.706]; P =. 596) at follow‐up, after adjustment for sex, age at index date, days from diagnosis to treatment, and comorbidities. Conclusion: Our study demonstrated that there was no difference of cardio‐ and cerebrovascular results between CPAP and surgery for patients with OSA in a 13‐year follow‐up. Level of Evidence: 3.