Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Jul;18(7):534-40.
doi: 10.1016/j.cardfail.2012.05.003.

Central sleep apnea is a predictor of cardiac readmission in hospitalized patients with systolic heart failure

Rami Khayat  1 , William Abraham, Brian Patt, Vincent Brinkman, Jacob Wannemacher, Kyle Porter, David Jarjoura
Affiliations

Central sleep apnea is a predictor of cardiac readmission in hospitalized patients with systolic heart failure

Rami Khayat et al. J Card Fail. 2012 Jul.

Abstract

Background: Hospitalized heart failure patients have a high readmission rate. We sought to determine the independent risk due to central sleep apnea (CSA) of readmission in patients with systolic heart failure (SHF).

Methods and results: This was a prospective observational cohort study of hospitalized patients with SHF. Patients underwent sleep studies during their hospitalization and were followed for 6 months to determine their rate of cardiac readmissions; 784 consecutive patients were included; 165 patients had CSA and 139 had no sleep-disordered breathing (SDB); the remainder had obstructive sleep apnea (OSA). The rate ratio for 6 months' cardiac readmissions was 1.53 (95% confidence interval 1.1-2.2; P = .03) in CSA patients compared with no SDB. This rate ratio was adjusted for systolic function, type of cardiomyopathy, age, weight, sex, diabetes, coronary disease, length of stay, admission sodium, creatinine, hemoglobin, blood pressure, and discharge medications. Severe OSA was also an independent predictor of readmissions with an adjusted rate ratio of 1.49 (P = .04).

Conclusion: In this first evaluation of the impact of SDB on cardiac readmissions in heart failure, CSA was an independent risk factor for 6 months' cardiac readmissions. The effect size of CSA exceeded that of all known predictors of heart failure readmissions.

PubMed Disclaimer

Figures

Figure-1
Figure-1. Selection and disposition of all patients
LVEF: Left ventricular ejection fraction; SDB: Sleep Disordered breathing; CSA: central sleep apnea; OSA: obstructive sleep apnea Fourteen patients died before discharge and were excluded from analysis (11 with OSA, 1 without SDB, and 1 with CSA). Another 91 patients had no recorded follow up or mortality data and could not be contacted, so missing data strategy was applied as described in the methods section (18 CSA patients, 21 patients with no SDB, and 57 OSA patients).
Figure-2
Figure-2. Comparison of Distribution of Cardiac readmissions in 6 months between patients with CSA and patients with no SDB
Distribution of cardiac readmission counts within 6 months; SDB: Sleep Disordered breathing; CSA: central sleep apnea; Note the higher percent of patients readmitted for each count in the CSA group.
See this image and copyright information in PMC

References

    1. From AM, Leibson CL, Bursi F, Redfield MM, Weston SA, Jacobsen SJ, Rodeheffer RJ, Roger VL. Diabetes in heart failure: prevalence and impact on outcome in the population. Am J Med. 2006 Jul;119(7):591–9. - PubMed
    1. Barker WH, Mullooly JP, Getchell W. Changing incidence and survival for heart failure in a well-defined older population, 1970-1974 and 1990-1994. Circulation. 2006 Feb 14;113(6):799–805. - PubMed
    1. Lloyd-Jones D, Adams RJ, Brown TM, Carnethon M, Dai S, De Simone G, Ferguson TB, Ford E, Furie K, Gillespie C, Go A, Greenlund K, Haase N, Hailpern S, Ho PM, Howard V, Kissela B, Kittner S, Lackland D, Lisabeth L, Marelli A, McDermott MM, Meigs J, Mozaffarian D, Mussolino M, Nichol G, Roger VL, Rosamond W, Sacco R, Sorlie P, Thom T, Wasserthiel-Smoller S, Wong ND, Wylie-Rosett J. Heart disease and stroke statistics--2010 update: a report from the American Heart Association. Circulation. 2010 Feb 23;121(7):e46–e215. - PubMed
    1. Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee-for-service program. N Engl J Med. 2009 Apr 2;360(14):1418–28. - PubMed
    1. Muzzarelli S, Leibundgut G, Maeder MT, Rickli H, Handschin R, Gutmann M, Jeker U, Buser P, Pfisterer M, Brunner-La Rocca HP. Predictors of early readmission or death in elderly patients with heart failure. Am Heart J. 2010 Aug;160(2):308–14. - PubMed

Publication types