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. 2020 May 11;6(2):00101-2019.
doi: 10.1183/23120541.00101-2019. eCollection 2020 Apr.

Effect of ventilation therapy on mortality rate among obesity hypoventilation syndrome and obstructive sleep apnoea patients

Hanna-Riikka Kreivi  1 , Tuomas Itäluoma  1 , Adel Bachour  1
Affiliations

Effect of ventilation therapy on mortality rate among obesity hypoventilation syndrome and obstructive sleep apnoea patients

Hanna-Riikka Kreivi et al. ERJ Open Res. .

Abstract

Introduction: The prevalence of obesity is continually increasing worldwide, which increases the incidence of obesity hypoventilation syndrome (OHS) and its consequent mortality.

Methods: We reviewed the therapy mode, comorbidity and mortality of all OHS patients treated at our hospital between 2005 and 2016. The control group consisted of randomly selected patients with obstructive sleep apnoea (OSA) treated during the same period.

Results: We studied 206 OHS patients and 236 OSA patients. The OHS patients were older (56.3 versus 52.3 years, p<0.001) and heavier (body mass index 46.1 versus 32.2 kg·m-2, p<0.001), and the percentage of women was higher (41.2% versus 24.2%, p<0.001), respectively. The OHS patients had more hypertension (83% versus 61%, p<0.001) and diabetes (62% versus 31%, p<0.001) than the OSA patients, but no higher stroke (4% versus 8%, p=0.058) or ischaemic heart disease (14% versus 15%, p=0.437) incidence. The 5- and 10-year, unadjusted survival rates were lower among the OHS patients than among the OSA patients (83% versus 96% and 74% versus 91%, respectively; p<0.001). Differences in mortality rates were not related to age, sex or body mass index; covariates such as Charlson Comorbidity Index and ventilation therapy predicted survival. The mortality rate decreased significantly (p<0.001) both in OHS and OSA patients even after adjusting for covariates.

Conclusions: The mortality rate in OHS was significantly higher than that in OSA patients even after adjusting for covariates. Ventilation therapy by continuous positive airway pressure or noninvasive ventilation have reduced mortality significantly in all patients.

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Conflict of interest statement

Conflict of interest: H-R. Kreivi has nothing to disclose. Conflict of interest: T. Itäluoma has nothing to disclose. Conflict of interest: A. Bachour has nothing to disclose.

Figures

FIGURE 1
FIGURE 1
A survival curve of up to 25-year follow-up of obesity hypoventilation syndrome (OHS) and obstructive sleep apnoea (OSA) patients. a) No adjustment for covariates. b) Adjustment for Charlson Comorbidity Index, diabetes and ventilation therapy.
FIGURE 2
FIGURE 2
A survival curve of patients with obesity hypoventilation syndrome according to their ventilation therapy status. Adjustment was performed for the Charlson Comorbidity Index.
FIGURE 3
FIGURE 3
A survival curve of patients with obstructive sleep apnoea according to their ventilation therapy status. Adjustment was performed for the Charlson Comorbidity Index.
FIGURE 4
FIGURE 4
An adjusted survival curve for obesity hypoventilation syndrome and obstructive sleep apnoea patients according to ventilation status and percentage of days on which ventilation was used.
See this image and copyright information in PMC

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References

    1. American Academy of Sleep Medicine. International Classification of Sleep Disorders. 3rd Edn Westchester, AASM, 2014.
    1. Brown LK. Hypoventilation syndromes. Clin Chest Med 2010; 31: 249–270. doi:10.1016/j.ccm.2010.03.002 - DOI - PubMed
    1. Piper AJ, Grunstein RR. Obesity hypoventilation syndrome: mechanisms and management. Am J Respir Crit Care Med 2011; 183: 292–298. doi:10.1164/rccm.201008-1280CI - DOI - PubMed
    1. Javaheri S, Simbartl LA. Respiratory determinants of diurnal hypercapnia in obesity hypoventilation syndrome. What does weight have to do with it? Ann Am Thorac Soc 2014; 11: 945–950. doi:10.1513/AnnalsATS.201403-099OC - DOI - PubMed
    1. Piper AJ, Yee BJ. Hypoventilation syndromes. Compr Physiol 2014; 4: 1639–1676. doi:10.1002/cphy.c140008 - DOI - PubMed

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