The impact of comorbidities on the obstructive sleep apnea

Abstract

Introduction. Obstructive sleep apnoea (OSA) is highly prevalent and there is considerable evidence supporting an independent association with a wide range of co-morbidities including cardiovascular, endocrine and metabolic, neuropsychiatric, pulmonary, and renal. Aim of the study. The objective of this study is to assess the prevalance of major comorbidities associated with obstructive sleep apnea (OSA) and to examine the predictive role of Charlson comorbidity index (CCI) on mortality of patients with OSA associated with comorbidities. Materials and methods. This is a cross-sectional study of 67 patients diagnosed with OSA based on antropometric dates,cardiorespiratory polygraphy and AHI.Inclusion criteria were patients with diagnosis of OSA, who were aged 18 and above and had comorbidities. We assess patients with comorbodities through Charlson index adapted to International Classification of Disease (ICD-10) codes. Charlson Comorbidity Index (CCI) (Charlson et al., 1987) quantifies an individual’s burden of disease and corresponding 1-year mortality risk. Each comorbidity category has an associated weight (from 1 to 6), based on the adjusted risk of mortality or resource use, and the sum of all the weights results in a single comorbidity score for a patient. A score of zero indicates that no comorbidities were found. The higher the score, the more likely the predicted outcome will result in mortality or higher resource use. Results. We evaluated 67 patients with OSA (51 men and 16 women) with a mean age of 53.9 years (range 25–76 years). The prevalence of comorbidities were: hypertension (91%), obesity (85%), congestive heart failure (65%), pulmonary hypertension (26%), diabetes mellitus (25%), coronary heart disease (22%), etc. Based on the Charlson index of comorbidity the weighted index of comorbidity were: 0 for 6 patients, 1 for 17 patients,2 for 13 patients,3 for 13 patients,4 for 11 patients, 5 for 5 patients and 6 for 2 patients. Combined condition and agerelated score were: 0 for 2 patients,1 for 8 patients,2 for 10 patients, 3 for 12 patients,4 for 9 patients,5 for 8 patients,6 for 10 patients.7 for 1 patient and 8 for 1 patient.Patients with combined condition and age related score of 0 (2) estimated 10 year survival was 98 %, 1 (8) was 96%, 2 (10) was 90 %,3(12) was 77 %, 4 (9) was 53 %, 5 (9) was 21 %,6 was 2 %,7 was 0 %,8 was 0 %.Conclusions. Our study revealed that exists a strength association between 10 year survival rate and other two factors: age related score and weighted index of comorbidity.The cardiovascular diseases are the most predominant comorbidities at OSA patients.The patients with higher CCI scores had higher risk of mortality. The impact of comorbidities on the obstructive sleep apnea is significant.