Clinical and financial impact of sleep disordered breathing on heart failure admissions.
Clinical and financial impact of sleep disordered breathing on heart failure admissions.
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DOI：
10.1007/s11325-023-02813-4
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发表时间：
2023-10
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影响因子：
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睡眠呼吸障碍(SDB)对心力衰竭(HF)的影响日益受到重视。然而，支持量化SDB对心力衰竭住院的临床和财务影响的数据有限。睡眠心脏登记包括在单一心脏中心因心力衰竭住院期间接受住院睡眠测试的所有患者。重新接纳的数据和重新接纳的实际费用是从机构诚实的中间人那里获得的。根据住院患者的睡眠研究，患者被归类为无SDB、阻塞性睡眠呼吸暂停(OSA)或中枢性睡眠呼吸暂停(CSA)。计算出院后3个月和6个月的累计心脏再住院率和费用。对费用进行未经调整和调整(年龄、性别、体重指数和左心室射血分数)的建模。队列包括1547名患者，393名(25%)没有SDB，438名(28%)有CSA，716名(46%)有OSA。在出院后6个月内，195名CSA患者(45%)、264名OSA患者(37%)和109名非SDB患者(28%)需要再次入院。同样，两个SDB组的3个月和6个月死亡率均高于无SDB组。在出院后3个月和6个月时，OSA组和CSA组的未调整和调整后再入院成本均高于未使用SDB组，而CSA和OSA组的成本几乎是未使用SDB组的两倍(~ $16,000)至6个月(~ $9,000)。以前未确诊的OSA和CSA在心力衰竭住院患者中很常见，并与增加的再住院率和死亡率有关。
The impact of sleep disordered breathing (SDB) on heart failure (HF) is increasingly recognized. However, limited data exist in support of quantification of the clinical and financial impact of SDB on HF hospitalizations. A sleep-heart registry included all patients who underwent inpatient sleep testing during hospitalization for HF at a single cardiac center. Readmission data and actual costs of readmissions were obtained from the institutional honest broker. Patients were classified based on the inpatient sleep study as having no SDB, obstructive sleep apnea (OSA), or central sleep apnea (CSA). Cumulative cardiac readmission rates and costs through 3 and 6 months post-discharge were calculated. Unadjusted and adjusted (age, sex, body mass index, and left ventricular ejection fraction) modeling of cost was performed. The cohort consisted of 1547 patients, 393 (25%) had no SDB, 438 (28%) had CSA, and 716 (46%) had OSA. Within 6 months of discharge, 195 CSA patients (45%), 264 OSA patients (37%), and 109 no SDB patients (28%) required cardiovascular readmissions. Similarly, 3- and 6-month mortality rates were higher in both SDB groups than those with no SDB. Both unadjusted and adjusted readmission costs were higher in the OSA and CSA groups compared to no SDB group at 3 and 6 months post-discharge with the CSA and OSA group costs nearly double (~ $16,000) the no SDB group (~ $9000) through 6 months. Previously undiagnosed OSA and CSA are common in patients hospitalized with HF and are associated with increased readmissions rate and mortality.
影响因子：
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作者：
Kahwash, Rami;Kikta, Donald;Khayat, Rami
通讯作者：
Khayat, Rami