MORTALITY IN SLEEP-APNEA PATIENTS - A MULTIVARIATE-ANALYSIS OF RISK-FACTORS
MORTALITY IN SLEEP-APNEA PATIENTS - A MULTIVARIATE-ANALYSIS OF RISK-FACTORS
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DOI：
10.1093/sleep/18.3.149
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发表时间：
1995-04-01
期刊：
影响因子：
5.6
通讯作者：
RUBIN, AHE
中科院分区：
文献类型：
--
作者：
LAVIE, P;HERER, P;RUBIN, AHE
1976-1988年间，我们在Technion睡眠实验室监测的1620名成年男性和女性中诊断出睡眠呼吸暂停综合征(SAS)。他们确诊时的年龄从21岁到79岁不等。截至1990年，已有57名患者(53名男性和4名女性)死亡，其中53%死于呼吸-心血管疾病。仅为男性计算的观察/预期(O/E)死亡率显示70岁以下患者的超额死亡率。超额死亡率在第4年和第50年显著(分别为3.33P<；0.002；3.23P<；0.0002)。在70岁以上患者中，O/E为0.33(p<；0.0007)。采用分层多因素分析方法，采用4个固定变量[年龄、体重指数(BMI)、高血压和呼吸暂停指数]和4个附加变量(心脏病、肺病、糖尿病、呼吸暂停持续时间)，确定各种原因、心肺原因和心肌梗死(MI)死亡的预测因素。除了肺病和心脏病外，所有四个主要变量都被发现是各种原因死亡率的重要预测因素。除肺部疾病外，只有年龄和体重指数是心肺疾病死亡的显著预测因素。除肺部疾病外，年龄、BMI和高血压还能预测MI死亡。这些结果被解读为SAS间接影响死亡，很可能是通过高血压的危险因素。
During 1976-1988 we diagnosed sleep apnea syndrome (SAS) in 1,620 adult men and women monitored in the Technion sleep laboratories. Their age at the time of diagnosis ranged between 21 and 79 years. Fifty-seven patients (53 men and 4 women) had died by 1990, 53% due to respiratory-cardiovascular causes. The observed/expected (O/E) mortality rates, calculated for men only, revealed excess mortality of patients under 70 years old. Excess mortality was significant in the fourth and fifth decades (3.33, p < 0.002; 3.23, p < 0.0002, respectively). In patients older than 70 O/E was 0.33 (p < 0.0007). Hierarchical multivariate analysis with four fixed variables [age, body mass index (BMI), hypertension and apnea index] and four additional variables added manually one at a time (heart disease, lung disease, diabetes, apnea duration) was used to determine the predictors of death from all causes, cardiopulmonary causes and from myocardial infarction (MI). All four major variables were found to be significant predictors of mortality from all causes, in addition to lung disease and heart disease. Only age and BMI were significant predictors of cardiopulmonary deaths in addition to lung disease. Age, BMI and hypertension predicted MI deaths in addition to lung disease. These results were interpreted to suggest that SAS affects death indirectly, most probably by being a risk factor for hypertension.