OSA patients not treated with PAP - Evolution over 5 years according to the Baveno classification and cardiovascular outcomes
| Autor: | Daniela de Oliveira Werneck Rodrigues, R.J. Carneiro, M. van Zeller, Mariana Serino, Marta Drummond, Joana Ferra, Catarina Cardoso, Filipa Aguiar, Maria J. Redondo |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Sleep Apnea Obstructive medicine.medical_specialty business.industry End organ damage Polysomnography Mean age General Medicine Middle Aged Esophageal and Gastric Varices Logistic regression medicine.disease Severity of Illness Index Body Mass Index respiratory tract diseases Obstructive sleep apnea Internal medicine medicine Humans Female business Body mass index Cardiovascular outcomes |
| Zdroj: | Sleep Medicine. 88:1-6 |
| ISSN: | 1389-9457 |
| DOI: | 10.1016/j.sleep.2021.09.010 |
| Popis: | Introduction The evolution of patients with obstructive sleep apnea (OSA) non-eligible for PAP-therapy at diagnosis is unknown. Currently, the severity of OSA is based on the apnea-hypopnea index (AHI), but its prognostic relevance has raised concerns. The Baveno classification may allow a better stratification of severity and therapeutic guidance in OSA. Methods Patients with AHI≥5/h in 2015, classified into Baveno groups A and B and non-eligible for PAP therapy at diagnosis and over 5 years, were analyzed. Patients were reclassified into Baveno groups (A-D) and changes in groups over 5 years were explored. Patients in Baveno groups C and D, who developed major cardiovascular comorbidities (CVC) or end-organ damage (EOD group), were compared with patients in Baveno groups A and B (non-EOD group). To identify predictors of the development of major CVC or EOD, a logistic regression analysis was performed. Results There were 76 patients, 58% male, mean age 51.9 ± 10.1 years, mean body mass index (BMI) of 30.3 ± 5.0 kg/m2 and median AHI of 8.9 (5.9–12.0) events/h. At diagnosis, 46% and 54% of patients were classified into Baveno group A and group B, respectively. In total, 21% of patients developed major CVC or EOD (Baveno group C or D); higher age (p = 0.011) and BMI (p = 0.004) and a higher percentage of central apneas (p = 0.012) at diagnosis significantly predicted it, while sex, sleepiness, insomnia, AHI, ODI and T90 were not. Conclusions A significant percentage of patients non-eligible for PAP-therapy at diagnosis of OSA developed CVC or EOD; higher age and BMI and a higher percentage of central apneas were significant predictors. |
| Databáze: | OpenAIRE |
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