Nonadherence to CPAP Associated With Increased 30-Day Hospital Readmissions.

Autor:	Truong KK; Department of Internal Medicine, University of California Irvine School of Medicine, Irvine, California., De Jardin R; Section of Pulmonary, Critical Care, and Sleep Medicine, Veterans Affairs Long Beach Healthcare System, Long Beach, California., Massoudi N; Epidemiology and Infection Prevention, University of California, Los Angeles, California., Hashemzadeh M; Section of Pulmonary, Critical Care, and Sleep Medicine, Veterans Affairs Long Beach Healthcare System, Long Beach, California., Jafari B; Department of Internal Medicine, University of California Irvine School of Medicine, Irvine, California.; Section of Pulmonary, Critical Care, and Sleep Medicine, Veterans Affairs Long Beach Healthcare System, Long Beach, California.
Jazyk:	angličtina
Zdroj:	Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine [J Clin Sleep Med] 2018 Feb 15; Vol. 14 (2), pp. 183-189. Date of Electronic Publication: 2018 Feb 15.
DOI:	10.5664/jcsm.6928
Abstrakt:	Study Objectives: The primary objective of this study was to determine if nonadherence to continuous positive airway pressure (CPAP) is associated with increased 30-day all-cause, cardiovascular-cause, and pulmonary-cause hospital readmissions. Methods: Retrospective cohort study at a Veterans Affairs hospital of patients with obstructive sleep apnea (OSA) who were hospitalized from January 1, 2007 to December 31, 2015. Odds ratio of 30-day readmission was calculated for all-cause, cardiovascular-cause, and pulmonary-cause readmissions. Logistic regression model was used to evaluate odds of nonadherent versus adherent group while adjusting for age, sex, body mass index, living situation, race, comorbidities, and medication adherence. Results: Out of 2,077 records reviewed, 345 patients (183 adherent and 162 nonadherent) met our inclusion criteria. The adherent group had a total of 215 initial admissions, and the nonadherent group had a total of 268 index admissions. Thirty-day all-cause readmission rate was significantly higher in the nonadherent group, with an adjusted odds ratio (OR) of 3.52 (95% confidence interval [CI], 2.04-6.08, P < .001). Thirty-day cardiovascular-cause readmission rate was significantly higher in the nonadherent group, with an adjusted OR of 2.31 (95% CI, 1.11-4.78, P = .024). Difference in 30-day pulmonary-cause readmissions was not statistically significant, with an adjusted OR of 3.66 (95% CI, 0.41-32.76, P = .25). Conclusions: Nonadherence to CPAP is associated with increased 30-day all-cause and cardiovascular-cause readmission in patients with OSA. Ensuring CPAP adherence is crucial in addressing general and cardiovascular-related healthcare utilization and morbidity in patients with OSA. Commentary: A commentary on this article appears in this issue on page 161. (© 2018 American Academy of Sleep Medicine)
Databáze:	MEDLINE
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