Ambulatory Office Visits and Medical Comorbidities Associated with Obstructive Sleep Apnea
Ambulatory Office Visits and Medical Comorbidities Associated with Obstructive Sleep Apnea
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DOI：
10.1177/0194599812459850
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发表时间：
2012-12-01
影响因子：
3.4
通讯作者：
Kepnes, Lynn J.
中科院分区：
文献类型：
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作者：
Bhattacharyya, Neil;Kepnes, Lynn J.
客观的。 (1) 了解美国阻塞性睡眠呼吸暂停 (OSA) 门诊就诊的流行病学。 (2) 量化 OSA 背景下可能发生的合并症的患病率。方法。从 2008-2009 年全国门诊医疗调查和全国医院门诊医疗调查中提取了诊断为 OSA 的成人病例。确定了 OSA 的流行病学。还确定了合并优先疾病（肥胖、哮喘、脑血管疾病、抑郁症、高血压和缺血性心脏病）的患病率。研究设计。国家调查数据库的横断面分析。设置。美国的门诊护理环境。结果。据估计，每年有 4.1 +/- 120 万人次被诊断为 OSA（60% +/- 3.2% 为男性；平均年龄为 56.4 +/- 0.9 岁）。每年有 419,000 +/- 28,000 名耳鼻喉科医生因 OSA 就诊。合并症为肥胖（23.8%+/-5.2%）、哮喘（14.3%+/-3.0%）、脑血管疾病（2.5%+/-1.5%）、抑郁症（23.2%+/-2.6%）、高血压53.8%+/-3.9%）和缺血性心脏病（10.3%+/-3.0%）。调整年龄、性别、民族、肥胖和种族后，发现患有 OSA 的肥胖 (3.6，P < .001)、哮喘 (2.7，P < .001)、抑郁 (2.5，P < .001) 和高血压 (2.0，P < .001) 的几率显着增加。未发现脑血管疾病和缺血性心脏病的发病率增加（分别为 P = .725 和 P = .083）。结论。阻塞性睡眠呼吸暂停是门诊和耳鼻喉科护理中相对常见的诊断。它与美国几种关键优先医疗保健状况的患病率显着增加有关。耳鼻喉科医生和医疗保健提供者应该意识到这些关联，了解 OSA 对整体健康的潜在广泛影响。
Objective. (1) Understand the epidemiology of obstructive sleep apnea (OSA) ambulatory office visits in the United States. (2) Quantify the prevalence of comorbid illnesses that are likely to occur in the setting of OSA.Methods. From the 2008-2009 National Ambulatory Medical Care Surveys and National Hospital Ambulatory Medical Care Surveys, adult cases with a diagnosis of OSA were extracted. The epidemiology of OSA was determined. The prevalences of comorbid priority illnesses (obesity, asthma, cerebrovascular disease, depression, hypertension, and ischemic heart disease) were also determined.Study Design. Cross-sectional analysis of a national survey database.Setting. Ambulatory care settings in the United States.Results. There were an estimated 4.1 +/- 1.2 million annual visits with a diagnosis of OSA (60% +/- 3.2% men; mean age, 56.4 +/- 0.9 years). There were 419,000 +/- 28,000 visits annually to otolaryngologists for OSA. Comorbid illnesses were obesity (23.8% +/- 5.2%), asthma (14.3% +/- 3.0%), cerebrovascular disease (2.5% +/- 1.5%), depression (23.2% +/- 2.6%), hypertension 53.8% +/- 3.9%), and ischemic heart disease (10.3% +/- 3.0%). Adjusting for age, sex, ethnicity, obesity, and race, statistically significant increased odds for the presence of obesity (3.6, P < .001), asthma (2.7, P < .001), depression (2.5, P < .001), and hypertension (2.0, P < .001) with OSA were noted. Increased odds for cerebrovascular disease and ischemic heart disease were not identified (P = .725 and P = .083, respectively).Conclusion. Obstructive sleep apnea is a relatively common diagnosis in ambulatory and otolaryngologic care. It is associated with a significantly increased prevalence of several key priority health care conditions in the United States. Otolaryngologists and health care providers should be aware of these associations, understanding the potentially broad impact of OSA on general health.