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. 2017 Oct;40(10):873-878.
doi: 10.1002/clc.22738. Epub 2017 Jun 6.

Obstructive sleep apnea is associated with increased readmission in heart failure patients

Alex Sommerfeld  1   2 , Andrew D Althouse  1   3 , Jennifer Prince  1 , Charles W Atwood  4 , Suresh R Mulukutla  1   3 , Gavin W Hickey  1   3
Affiliations

Obstructive sleep apnea is associated with increased readmission in heart failure patients

Alex Sommerfeld et al. Clin Cardiol. 2017 Oct.

Abstract

Background: Heart failure (HF) readmission rates have become an increasingly important quality metric since the advent of the Hospital Readmissions Reduction Program. Despite many well-intentioned efforts to reduce readmissions, clinicians continue to struggle with the problem of high HF readmission rates.

Hypothesis: HF patients with obstructive sleep apnea (OSA) will have higher burden of rehospitalization and mortality than HF patients without OSA.

Methods: Our study included 344 patient encounters (among 271 unique patients) with a diagnosis of HF from September 2014 through September 2015. Our primary endpoints were all-cause readmission within 30 and 90 days. Multivariate logistic regression was used to assess the relationship between OSA and readmission when accounting for potential confounders.

Results: The patients' were 72 ± 10 years old, and predominantly white (76.2%) and male (99.4%). Among the 344 patient encounters, 247 (71.8%) had diagnosed coronary artery disease, 159 (46.2%) had atrial fibrillation, and 99 (28%) had obstructive sleep apnea (OSA). Notably, patients with OSA had an elevated rate of readmission within 30 days (OSA: 30.3% vs no OSA: 19.6%, P = 0.037) and within 90 days (OSA: 57.6% vs no OSA: 36.3P < 0.01). Patients with OSA had increased risk of readmission within 90 days (odds ratio: 2.38, 95% confidence interval: 1.47-3.83, P < 0.01) even after adjustment for potential confounders of age, race, obesity, diabetes, and chronic obstructive pulmonary disease.

Conclusions: HF patients with OSA have an elevated rate of readmission compared to the general HF population, particularly within the first 90 days after discharge.

Keywords: Heart failure/cardiac transplantation/cardiomyopathy/myocarditis; obstructive sleep apnea; readmissions.

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Conflict of interest statement

The authors declare no potential conflicts of interest.

Figures

Figure 1
Figure 1
Freedom from all‐cause readmission by OSA status. Abbreviations: OSA, obstructive sleep apnea.
Figure 2
Figure 2
Freedom from mortality by OSA status. Abbreviations: OSA, obstructive sleep apnea.
See this image and copyright information in PMC

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