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Obstructive Sleep Apnea Is Associated with Worsened Hospital Outcomes in Children Hospitalized with Asthma.

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Title: Obstructive Sleep Apnea Is Associated with Worsened Hospital Outcomes in Children Hospitalized with Asthma.
Authors: Khatana J; Department of Pediatrics, Metro Health Medical Center, Case Western Reserve University School of Medicine, 2500 Metrohealth Dr, Cleveland, OH 44109, USA., Thavamani A; Division of Pediatric Gastroenterology, Hepatology and Nutrition, UH Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Adelbert Rd 2101, Cleveland, OH 44106, USA., Umapathi KK; Division of Pediatric Cardiology, West Virginia University, Charleston Area Medical Center, 830 Pennsylvania Avenue, Charleston, SC 25302, USA., Sankararaman S; Division of Pediatric Gastroenterology, Hepatology and Nutrition, UH Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Adelbert Rd 2101, Cleveland, OH 44106, USA., Roy A; Department of Pediatrics, Metro Health Medical Center, Case Western Reserve University School of Medicine, 2500 Metrohealth Dr, Cleveland, OH 44109, USA.
Source: Children (Basel, Switzerland) [Children (Basel)] 2024 Aug 22; Vol. 11 (8). Date of Electronic Publication: 2024 Aug 22.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: MDPI AG Country of Publication: Switzerland NLM ID: 101648936 Publication Model: Electronic Cited Medium: Print ISSN: 2227-9067 (Print) Linking ISSN: 22279067 NLM ISO Abbreviation: Children (Basel) Subsets: PubMed not MEDLINE
Imprint Name(s): Original Publication: Basel, Switzerland : MDPI AG, [2014]-
Abstract: Background: Studies have shown a bidirectional relationship between asthma and obstructive sleep apnea (OSA). However, there is a paucity of national-level data evaluating the impact of OSA on hospital outcomes in pediatric hospitalizations for asthma.
Methods: We analyzed the National Inpatient Sample and Kids Inpatient Database to include all pediatric hospitalizations with a primary diagnosis of asthma between 2003-2016. Using ICD codes, the pediatric asthma cohort was divided into two groups: those with and those without a concomitant diagnosis of OSA. The primary outcomes were in-hospital mortality and the need for mechanical ventilation. The secondary outcomes were the lengths of each hospital stay and total hospitalization charges.
Results: We analyzed 1,606,248 hospitalizations during the 14-year study period. The overall prevalence rate of OSA was 0.7%. Patients with asthma and OSA were significantly older (8.2 versus 5.9 years) and were more often male, p < 0.001. The OSA group had several increased comorbidities. The overall mortality rate was 0.03%, and multivariate regression analysis showed that OSA was associated with 4.3 times higher odds of in-hospital mortality (95% CI: 2.4 to 7.6, p < 0.001). Furthermore, OSA was associated with a 5.2 times greater need for mechanical ventilation (95% CI: 4.8 to 5.5, p < 0.001). Linear regression analyses demonstrated that OSA independently contributed an additional 0.82 days to the hospital stay length (95% CI: 0.79 to 0.86, p < 0.001) and an extra 10,479 USD (95% CI: 10,110 to 10,848, p < 0.001) in hospitalization charges.
Conclusion: OSA in children admitted with asthma is associated with poor hospital outcomes such as increased mortality risk, the need for mechanical ventilation, and increased healthcare utilization.
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Contributed Indexing: Keywords: asthma; mechanical ventilation; mortality; obstructive sleep apnea; pediatric hopsitalization; population based analysis
Entry Date(s): Date Created: 20240829 Latest Revision: 20240901
Update Code: 20260130
PubMed Central ID: PMC11353067
DOI: 10.3390/children11081029
PMID: 39201964
Database: MEDLINE
Description
ISSN:2227-9067
DOI:10.3390/children11081029