0565 Long-Term Survival in Veterans with Sleep Apnea

• Published in: Sleep (New York, N.Y.) N.Y.), 2018-04, Vol.41 (suppl_1), p.A210-A211
• Main Authors: Jara, S M, Phipps, A I, Maynard, C, Weaver, E M
• Format: Article
• Language: English
• Subjects: Codes; Comorbidity; Continuous positive airway pressure; Sleep apnea; Surgery; Veterans
• ISSN: 0161-8105; 1550-9109
• DOI: 10.1093/sleep/zsy061.564

Abstract Introduction Untreated obstructive sleep apnea (OSA) decreases long-term survival. OSA treatment, either continuous positive airway pressure (CPAP) or surgery, appears to improve survival. However, the duration of these survival benefits is unclear. We tested the association between OSA treatment and survival in a large, long-term cohort of veterans. Methods This retrospective cohort study included all adult veterans diagnosed with OSA in any Veterans Affairs (VA) inpatient facility 1993–2013 or outpatient facility 1997–2013. Subjects were identified by ICD-9 diagnosis codes in VA inpatient and outpatient files. OSA treatment (untreated versus prescribed CPAP versus surgery) was determined by ICD-9 or CPT procedure codes. Patients without a procedure code were considered untreated. Vital status as of 2/1/2017 was extracted from VA Vital Status Files. The Charlson Comorbidity Index was calculated from ICD-9 diagnosis codes from two years prior to OSA diagnosis. Survival was compared by OSA treatment (untreated versus prescribed CPAP versus surgery) using Kaplan-Meier estimates and mortality hazard with Cox regression, adjusting for age, sex, body mass index (BMI), comorbidity, and year of diagnosis. Results The cohort included 638,029 untreated, 231,928 CPAP, and 6,977 surgery patients (N=876,934) with mean age 61+/-13 years, mostly male (96%), and some obese (48% BMI>30). The majority (76%) was diagnosed with OSA since 2010. Survival at 5 years was 76% for untreated, 84% for CPAP, and 83% for surgery (P