title: Healthcare burden of obstructive sleep apnea and obesity among asthma hospitalizations: Results from the U.S.-based Nationwide Inpatient Sample.
abstract: Studies have highlighted the significant comorbidities of both obesity and obstructive sleep apnea (OSA) among asthma patients in outpatient settings, but such data in the inpatient setting is sparse.
  
  
  
  Using 2009-2011 U.S. Nationwide Inpatient Sample; survey-weighted regression analyses were conducted to address the role of obesity, OSA, and both obesity and OSA on length of stay (LOS), total hospital charges, need for respiratory therapy, and disposition among adults with primary asthma hospitalization (n = 179,789).
  
  
  
  Males had a higher prevalence of OSA than females (5.23% vs. 3.88%), while females had a higher prevalence of obesity (17.21% vs. 8.95%) and both obesity and OSA (7.11% vs. 6.19%). Increased hospital LOS was associated with presence of obesity (incidence rate ratio [IRR] males = 1.07, IRR females = 1.08), OSA (IRR males = 1.07, IRR females = 1.14), and both obesity and OSA (IRR males = 1.19, IRR females = 1.24). Increased total hospital charges was related to obesity (8.64% for males and 9.61% for females), OSA (15.39% for males and 19.13% for females), and both comorbidities (24.94% for males and 28.50% for females). Presence of OSA alone increased odds of need for respiratory therapy for males (odds ratio [OR] = 2.56) and females (OR = 3.22), as did presence of both comorbidities (OR males = 2.85, OR females = 3.60). Odds of routine disposition was lower among females with both comorbidities (OR = 0.82).
  
  
  
  Compared to obesity alone, OSA and both obesity and OSA are associated with increased health resource utilization and poorer inpatient outcomes. This demonstrates the need for further clinical investigations of early detection of OSA among such at-risk populations.
authors: Department of Health Science and Human Ecology, California State University, San Bernardino, USA.
authors: Monideepa B
authors: MB
authors: Becerra
authors: School of Allied Health Professions, Loma Linda University, USA. Electronic address: bbecerra@llu.edu.
authors: Benjamin J
authors: BJ
authors: Becerra
authors: James B. Skatrud Pulmonary/Sleep Research Laboratory, Medical Service, William S. Middleton Memorial Veteran's Hospital, Madison, WI, USA; Division of Allergy, Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors: Mihaela
authors: M
authors: Teodorescu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000150:complications / Q000191:economics / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D017048:Health Care Costs; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007297:Inpatients; D007902:Length of Stay / Q000191:economics / Q000639:trends; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000191:economics* / Q000453:epidemiology; D015995:Prevalence; D012138:Respiratory Therapy / Q000191:economics; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000191:economics* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Asthma; Nationwide Inpatient Sample; Obesity; Obstructive sleep apnea; Respiratory therapy