Association of CPAP Prescription and Pneumonia Among Patients with Obstructive Sleep Apnea in the United States: A Retrospective Database Analysis.

IF 4 3区医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in Therapy Pub Date : 2025-09-15 DOI:10.1007/s12325-025-03343-z

Maria J Tort, Birol Emir, Jennifer L Nguyen, Deepa Malhotra, Chai Hyun Kim, Vincenza T Snow

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引用次数: 0

Abstract

Introduction: Continuous positive airway pressure (CPAP) is the first-line therapy for obstructive sleep apnea (OSA). We sought to understand whether CPAP prescription among adults diagnosed with OSA was associated with a higher likelihood of pneumonia diagnosis and inpatient hospitalization for pneumonia after adjusting for patient demographic characteristics and comorbidities.

Methods: This retrospective cohort study used de-identified data from the Optum Clinical Electronic Health Record (EHR) database for the time period January 2012 to December 2019. The study population comprised adults with an OSA diagnosis with and without CPAP prescription after the initial diagnosis. The primary outcome of interest was a pneumonia diagnosis in the first year following OSA diagnosis. Propensity score matching was used to balance the cohorts. Logistic regression was used to estimate the odds of developing pneumonia.

Results: There were 328,340 patients with an OSA diagnosis and evidence of CPAP prescription and 964,199 patients with an OSA diagnosis without evidence of CPAP prescription. After 1:1 propensity score matching, 326,145 were included in each cohort. The risk of pneumonia in any setting and in the inpatient setting was higher among patients with CPAP prescription, odds ratio (OR), 1.06 (95% CI: 1.03, 1.09) and 1.24 (95% CI, 1.20, 1.29), respectively. The odds of developing pneumonia increased in any setting when CPAP was initiated on the date of OSA diagnosis (OR = 1.68, 95% CI: 1.62-1.72) among all patients, for patients aged 65 + years (OR = 1.68, 95% CI: 1.47, 1.92), patients with obesity (OR = 1.59, 95% CI: 1.47, 1.72), and patients with a history of pneumonia (OR = 1.68, 95% CI: 1.41, 2.00).

Conclusion: This study indicates that among patients with OSA, CPAP initiation was associated with incident pneumonia, particularly inpatient pneumonia hospitalizations. Longer CPAP prescription, older age, obesity, and previous history of pneumonia further increased the risk of incident pneumonia associated with CPAP prescription.

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美国阻塞性睡眠呼吸暂停患者CPAP处方与肺炎的关系：回顾性数据库分析。

持续气道正压通气（CPAP）是治疗阻塞性睡眠呼吸暂停（OSA）的一线治疗方法。在调整患者人口统计学特征和合并症后，我们试图了解在诊断为OSA的成年人中使用CPAP处方是否与肺炎诊断和肺炎住院的更高可能性相关。方法：本回顾性队列研究使用2012年1月至2019年12月期间来自Optum临床电子健康记录（EHR）数据库的去识别数据。研究人群包括在初步诊断后有或没有CPAP处方的OSA诊断的成年人。研究的主要终点是OSA诊断后第一年的肺炎诊断。使用倾向评分匹配来平衡队列。采用Logistic回归估计发生肺炎的几率。结果：OSA诊断并有CPAP处方证据的患者328,340例，OSA诊断无CPAP处方证据的患者964,199例。在1:1的倾向评分匹配后，每个队列中包括326,145人。使用CPAP处方的患者在任何情况下和住院情况下发生肺炎的风险更高，优势比（OR）分别为1.06 （95% CI: 1.03, 1.09）和1.24 （95% CI, 1.20, 1.29）。在任何情况下，当CPAP在OSA诊断之日开始时，所有患者发生肺炎的几率都增加（OR = 1.68, 95% CI: 1.62-1.72），包括65岁以上患者（OR = 1.68, 95% CI: 1.47, 1.92）、肥胖患者（OR = 1.59, 95% CI: 1.47, 1.72）和有肺炎史的患者（OR = 1.68, 95% CI: 1.41, 2.00）。结论：本研究表明，在OSA患者中，CPAP启动与肺炎事件有关，特别是住院肺炎住院。CPAP处方时间较长、年龄较大、肥胖和既往肺炎史进一步增加了与CPAP处方相关的肺炎事件的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in Therapy 医学-药学

CiteScore

7.20

自引率

2.60%

发文量

353

审稿时长

6-12 weeks

期刊介绍： Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.