LONG-TERM OUTCOME FOR OBSTRUCTIVE SLEEP-APNEA SYNDROME PATIENTS - MORTALITY
LONG-TERM OUTCOME FOR OBSTRUCTIVE SLEEP-APNEA SYNDROME PATIENTS - MORTALITY
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DOI：
10.1378/chest.94.6.1200
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发表时间：
1988-12-01
期刊：
影响因子：
9.6
通讯作者：
GUILLEMINAULT, C
中科院分区：
文献类型：
--
作者：
PARTINEN, M;JAMIESON, A;GUILLEMINAULT, C
由于迄今为止阻塞性睡眠呼吸暂停综合征 (OSAS) 的实际死亡率和发病率尚不清楚，我们对 1972 年至 1980 年间在斯坦福睡眠障碍诊所就诊的 198 名 OSAS 患者进行了一项随访研究，其中建议对这些患者进行气管切开术（71 名患者）或减肥（127 名患者）。在五年随访中，所有死亡 (14) 均发生在接受减肥保守治疗的患者中（每五年每 100 名患者中有 11 人死亡）。 这些患者的五年粗血管死亡率也较高：每五年每 100 名患者有 6.3 例，年龄标准化血管死亡率为每五年每 100 名患者 5.9 例（95% 置信区间 [CI] 2.5-11.6），而手术治疗人群为每 100 例 0 例；尽管保守治疗组的平均呼吸暂停指数较低（43 vs 69）和平均体重指数较低（31 vs 34 kg/m2）。假设手术治疗组五年随访中可能有一名患者死亡，保守治疗组五年后血管死亡率的年龄调整几率为 4.7。因此，我们的数据鼓励对 OSAS 患者进行“积极”治疗。
As the actual mortality and morbidity of obstructive sleep apnea syndrome (OSAS) have been unknown heretofore, we undertook a follow-up study of 198 OSAS patients seen at the Stanford Sleep Disorders Clinic between 1972 and 1980, for whom either tracheostomy (71 patients) or weight loss (127 patients) had been recommended. At five-year follow-up, all of the deaths (14) had occurred among those conservatively treated with weight-loss (a mortality rate of 11 per 100 patients per five years). These patients also had a higher five-year crude vascular mortality rate: 6.3 per 100 patients per five years, with an age-standardized vascular mortality rate of 5.9 per 100 patients per five years (95 percent confidence interval [CI] 2.5-11.6) vs 0 per 100 for the surgically treated populations; this despite a lower mean apnea index (43 versus 69) and a lower mean body mass index (31 versus 34 kg/m2) in the conservatively treated group. With the fictional adjuction of one possible death a five-year follow-up in the surgically treated group, the age-adjusted odds of vascular mortality at five years for the conservatively treated group was 4.7. Our data therefore encourage "aggressive" treatment for patients with OSAS.