Association Between Obstructive Sleep Apnea and Reduced Mortality in Critically Ill Patients: A Propensity Score-Based Analysis

Background: The impact of obstructive sleep apnea (OSA) on the prognosis of intensive care unit (ICU) patients remains controversial. Thus, this study aimed to determine the association between OSA status and outcomes in ICU patients. Methods: We conducted a retrospective cohort study composed of 38,177 critically ill patients from the Medical Information Mart for Intensive Care III (MIMIC-III) database. Propensity score matching was used to evaluate the association between OSA and mortality in ICU adults. Results: A total of 38,177 critically ill patients were included in this study. Among them, 1428 (3.71%) patients had OSA. Before matching, patients with OSA had a significantly lower 28-day mortality (relative risk (RR), 0.47; 95% confidence interval (CI), 0.38-0.58), 90-day mortality (RR, 0.50; 95% CI, 0.43-0.60), ICU mortality (RR, 0.41; 95% CI, 0.31- 0.54), and in-hospital mortality (RR, 0.46; 95% CI, 0.36-0.57). After adjusting with propensity-score matching, the findings of reduced risk of mortality remained unchanged. The RR of 28-day mortality, 90-day mortality, ICU mortality, in-hospital mortality was 0.57 (95% CI, 0.34-0.57), 0.53 (95% CI, 0.40-0.70), 0.54 (95% CI, 0.37-0.79), and 0.55 (95% CI, 0.39-0.77), respectively. Conclusion: This study indicated that ICU patients with OSA had a significantly lower risk of mortality compared with those without OSA.