Obstructive Sleep Apnea and Risk of Cardiovascular Events or All-Cause Mortality in Patients With Spinal Cord Injuries: A Descriptive Study.

IF 2.4 4区 医学 Q1 REHABILITATION
Julie Di Maria, Jonathan Levy, Djamel Bensmail, Omar Ben Hadj Salem, Thibaud Lansaman, Hélène Prigent, Sarah Hartley, Antoine Léotard
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Abstract

Objective: Obstructive sleep apnea is associated with an increased risk of cardiovascular morbi-mortality, but this relationship has never been studied in patients with spinal cord injury. Our objective was to describe the impact of obstructive sleep apnea on the risk of major adverse cardiovascular events and all-cause mortality in patients with spinal cord injury.

Design: This is a retrospective, descriptive, single-center study.

Results: Out of 269 spinal cord injury patients, 177 had obstructive sleep apnea and 32 experienced a major adverse cardiovascular events-all-cause mortality. Univariate analysis shows that age, sex, hypertension, diabetes, dyslipidemia and Apnea Hypopnea Index were associated with major adverse cardiovascular events-all-cause mortality occurrence. Age, sex, diabetes, and dyslipidemia but not hypertension nor Apnea Hypopnea Index was independently associated with major adverse cardiovascular events-all-cause mortality in multivariate analysis. Log rank test suggest a significant impact of obstructive sleep apnea on major adverse cardiovascular events-all-cause mortality occurrence during spinal cord injury follow-up ( P = 0.047).

Conclusions: Obstructive sleep apnea severity was not independently associated with major adverse cardiovascular events-all-cause mortality in spinal cord injury, but our descriptive study suggests that larger prospective studies are required. These could potentially use the national health data hub to maximize inclusions and restrain the selection bias due to our mono centric (and highly specialized) design.

脊髓损伤患者的阻塞性睡眠呼吸暂停与心血管事件或全因死亡率的风险:一项描述性研究
目的:阻塞性睡眠呼吸暂停(OSA)与心血管疾病发病-死亡风险增加有关,但这种关系从未在脊髓损伤(SCI)患者中进行过研究。我们的目的是描述OSA对SCI患者主要不良心血管事件(MACE)和全因死亡率(ACM)的影响。设计:回顾性、描述性、单中心研究。结果:269例SCI患者中,177例发生OSA, 32例发生MACE-ACM。单因素分析显示,年龄、性别、高血压、糖尿病、血脂异常和呼吸暂停低通气指数(AHI)与MACE-ACM的发生相关。在多变量分析中,年龄、性别、糖尿病和血脂异常与MACE-ACM独立相关,但与高血压和AHI无关。Log rank检验显示,OSA对SCI随访期间MACE-ACM的发生有显著影响(p = 0.047)。结论:OSA严重程度与SCI患者MACE-ACM没有独立相关性,但我们的描述性研究表明,需要更大规模的前瞻性研究。这些可能潜在地使用国家卫生数据中心来最大限度地纳入并抑制由于我们的单中心(和高度专业化)设计而导致的选择偏差。
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来源期刊
CiteScore
4.60
自引率
6.70%
发文量
423
审稿时长
1 months
期刊介绍: American Journal of Physical Medicine & Rehabilitation focuses on the practice, research and educational aspects of physical medicine and rehabilitation. Monthly issues keep physiatrists up-to-date on the optimal functional restoration of patients with disabilities, physical treatment of neuromuscular impairments, the development of new rehabilitative technologies, and the use of electrodiagnostic studies. The Journal publishes cutting-edge basic and clinical research, clinical case reports and in-depth topical reviews of interest to rehabilitation professionals. Topics include prevention, diagnosis, treatment, and rehabilitation of musculoskeletal conditions, brain injury, spinal cord injury, cardiopulmonary disease, trauma, acute and chronic pain, amputation, prosthetics and orthotics, mobility, gait, and pediatrics as well as areas related to education and administration. Other important areas of interest include cancer rehabilitation, aging, and exercise. The Journal has recently published a series of articles on the topic of outcomes research. This well-established journal is the official scholarly publication of the Association of Academic Physiatrists (AAP).
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