Impact of obstructive sleep apnea on the obesity paradox in critically ill patients

Objective: Patients admitted to an intensive care unit (ICU) frequently suffer from multiple chronic diseases, including obstructive sleep apnea (OSA). Until recently OSA was not considered as a key determinant in an ICU patient's prognosis. The objective of this study was to document the impact of OSA on the prognosis of KU patients. Methods: Data were retrospectively collected concerning adult patients admitted to ICU at two university hospitals. In a nested study OSA status was checked using the hospital electronic medical records to identify exposed and unexposed cases. The following outcomes were considered: length of stay in the KU, KU mortality, inhospital mortality, ventilator-associated pneumonia (VAP). Results: Out of 5146 patients included in the study, 289 had OSA at ICU admission (5.6%). After matching, the overall impact of OSA on length of ICU stay was not significant (p =.24). In a predefined subgroup analysis, there was a significant impact of OSA on the length of ICU stay for patients with BMI over 40 kg/m(2) (IRR: 1.56 [1.05; 232], p = .03). OSA status had no impact on ICU or hospital mortality and VAP. Conclusion: In general, known OSA did not increase the ICU stay except for patients with both OSA and morbid obesity. (C) 2019 Published by Elsevier Inc.