title: Association between obstructive sleep apnea and deep vein thrombosis / pulmonary embolism: a population-based retrospective cohort study.
abstract: BACKGROUND
  Obstructive sleep apnea (OSA) is a major contributor to cardiovascular disease, and may cause severe morbidity and mortality. Recent studies have indicated that OSA patients exhibited elevated platelet activity, fibrinogen levels, and platelet aggregation.
  
  
  OBJECTIVE
  We investigated the risk of deep vein thrombosis (DVT) and pulmonary embolism (PE) in patients diagnosed with OSA compared with age- and sex-matched unaffected people.
  
  
  METHODS
  This longitudinal, nationwide, population-based cohort study was conducted using data from Taiwan National Health Insurance Research Database (NHIRD) recorded between January 2000 and December 2011. The study consisted of 3511 patients with OSA and 35110 matched comparison individuals. A Cox proportional hazard regression was used to compute the risk of DVT and PE in patients with OSA compared with those without OSA.
  
  
  RESULTS
  The DVT and PE risks were 3.50- and 3.97-fold higher (95% CI=1.83-6.69 and 1.85-8.51) respectively, in the OSA cohort than in the reference cohort after we adjusted for age, sex, and comorbidities.
  
  
  CONCLUSIONS
  This nationwide population-based cohort study indicates that patients with OSA exhibit a higher risk of subsequent DVT and PE.
authors: Department of Respiratory Therapy, China Medical University Hospital, Taichung, Taiwan; China Medical University, Taichung, Taiwan.
authors: Yi-Hao
authors: YH
authors: Peng
authors: China Medical University, Taichung, Taiwan; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
authors: Wei-Chih
authors: WC
authors: Liao
authors: Department of Internal Medicine, Taichung Hospital, Department of Health, Executive Yuan, Taichung, Taiwan; Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan.
authors: Wei-Sheng
authors: WS
authors: Chung
authors: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
authors: Chih-Hsin
authors: CH
authors: Muo
authors: Department of Respiratory Therapy, China Medical University Hospital, Taichung, Taiwan; Department of Respiratory Therapy, China Medical University, Taichung, Taiwan.
authors: Chia-Chen
authors: CC
authors: Chu
authors: Department of Respiratory Therapy, China Medical University Hospital, Taichung, Taiwan; Department of Respiratory Therapy, China Medical University, Taichung, Taiwan.
authors: Chin-Jung
authors: CJ
authors: Liu
authors: Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan. Electronic address: d10040@mail.cmuh.org.tw.
authors: Chia-Hung
authors: CH
authors: Kao
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications*; D013624:Taiwan / Q000453:epidemiology; D020246:Venous Thrombosis / Q000209:etiology*; D055815:Young Adult
keywords: Cohort study; Deep vein thrombosis (DVT); Obstructive sleep apnea (OSA); Pulmonary embolism (PE); Venous thromboembolism (VTE)