1146 OBSTRUCTIVE SLEEP APNEA IS ASSOCIATED WITH BETTER INPATIENT OUTCOMES IN PATIENTS WITH ISCHEMIC STROKE

• Published in: Sleep (New York, N.Y.) N.Y.), 2017-04, Vol.40 (suppl_1), p.A428-A428
• Main Authors: Low, D, Elkind, M
• Format: Article
• Language: English
• Subjects: Hypertension; Hypoxia; Sleep apnea; Stroke
• ISSN: 0161-8105; 1550-9109
• DOI: 10.1093/sleepj/zsx050.1145

Abstract Introduction: Hypoxic preconditioning induces stroke tolerance in mice. Patients with OSA often have intermittent hypoxia during sleep. As this could be a form of hypoxic preconditioning, it may lead to improved outcomes in patients with IS. The aim of this study was to compare the outcomes of death and discharge status among patients with ischemic stroke (IS), with or without the comorbidity of obstructive sleep apnea (OSA). Methods: We investigated the 2007 to 2009 inpatient administrative database of the Healthcare Cost and Utilization Project (HCUP) that uses ICD-9 codes to define diagnoses. We applied unadjusted and adjusted logistic regression to analyze the relationship between OSA and the outcome measures of death and discharge status. We defined good discharge status as a discharge to acute rehabilitation facility or home. Poor discharge status was defined as a discharge to an intermediate care facility, skilled nursing facility, another kind of facility, home health, leaving against medical advice, or death. Results: We identified 134,399 patients with IS, of whom 1,960 patients had OSA. In an unadjusted model, patients with OSA were found to have lower odds of death [OR(95%CI) 0.52(0.41–0.65)]. After adjusting for insurance, gender, age, race, obesity, hypertension, diabetes mellitus (DM) and tobacco use disorder, OSA was still associated with lower odds of death [OR(95%CI) 0.68(0.53–0.86)]. In an unadjusted model, we found that OSA was associated with lower odds of poor discharge status [OR(95%CI) 0.62 (0.54–0.71)]. Furthermore, after adjusting for age, gender, race, insurance status, obesity, hypertension, DM and tobacco use disorder, OSA was still associated with lower odds of poor discharge status [OR(95%CI) 0.84(0.73–0.98)]. Conclusion: In this study of patients with IS, OSA was associated with lower odds of poor discharge status and death. Hypoxic preconditioning in patients with OSA could be a potential mechanism responsible for the better inpatient outcomes following IS. Support (If Any):