title: Obstructive sleep apnea and acute respiratory failure: An analysis of mortality risk in patients with pneumonia requiring invasive mechanical ventilation.
abstract: OBJECTIVE
  Although obstructive sleep apnea (OSA) is common and pneumonia is a frequent cause of acute respiratory failure requiring admission to the intensive care unit, little is known about the effect of OSA on this patient population. This study examined outcomes associated with OSA in patients with pneumonia requiring invasive mechanical ventilation.
  
  
  METHODS
  The Nationwide Inpatient Sample was investigated for discharges with a primary diagnosis of pneumonia requiring invasive mechanical ventilation between 2009 and 2011. Persons aged 18 to 75 years with OSA were compared with patients without OSA. Outcomes included in-hospital mortality and nonroutine discharges.
  
  
  RESULTS
  Among 74032 hospitalizations, 13.8% (10227) were obese, and 10.3% (7610) had OSA. Obstructive sleep apnea patients had decreased in-hospital mortality (17.0% vs 25.8%; P < .01) and nonroutine discharge (74.4% vs 79.4%; P < .01) when compared with non-OSA patients. In adjusted logistic models, OSA was associated with a 27% decreased risk of in-hospital mortality (odds ratio, 0.73; 95% confidence interval, 0.68-0.79; P < .01) and a 21% decreased risk of nonroutine discharge (odds ratio, 0.79; 95% confidence interval, 0.74-0.84; P < .01).
  
  
  CONCLUSIONS
  In mechanically ventilated patients with pneumonia, OSA was associated decreased in-hospital mortality and nonroutine discharge. It is possible that differences in treatment pattern may partially explain improved survival.
authors: Department of Medicine, Mount Sinai St Luke's and Mount Sinai Roosevelt, Icahn School of Medicine at Mount Sinai, New York, NY; Division of Pulmonary and Critical Care Medicine, Mount Sinai St Luke's and Mount Sinai Roosevelt, Icahn School of Medicine at Mount Sinai, New York, NY.
authors: Raymonde E
authors: RE
authors: Jean
authors: Department of Medicine, Mount Sinai St Luke's and Mount Sinai Roosevelt, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address: cgibson3@chpnet.org.
authors: Charlisa D
authors: CD
authors: Gibson
authors: Department of Surgery, Yale School of Medicine, New Haven, CT.
authors: Raymond A
authors: RA
authors: Jean
authors: Department of Medicine, Mount Sinai St Luke's and Mount Sinai Roosevelt, Icahn School of Medicine at Mount Sinai, New York, NY; Division of Pulmonary and Critical Care Medicine, Mount Sinai St Luke's and Mount Sinai Roosevelt, Icahn School of Medicine at Mount Sinai, New York, NY.
authors: Pius
authors: P
authors: Ochieng
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D015897:Comorbidity; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care; D011014:Pneumonia / Q000150:complications / Q000401:mortality* / Q000628:therapy; D012121:Respiration, Artificial / Q000379:methods*; D012131:Respiratory Insufficiency / Q000209:etiology / Q000401:mortality* / Q000628:therapy; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology*; D055815:Young Adult
keywords: Invasive mechanical ventilation; Pneumonia; Sleep apnea