The Association of Ankylosing Spondylitis and Obstructive Sleep Apnea: A Nationwide Sample 2016-2020
Recommended Citation
Alwarawrah Z, El Sharu H, Singh S, Hammami S, Antia A, Bishnoi A. The Association of Ankylosing Spondylitis and Obstructive Sleep Apnea: A Nationwide Sample 2016-2020. Am J Respir Crit Care Med 2024; 209.
Document Type
Conference Proceeding
Publication Date
5-21-2024
Publication Title
Am J Respir Crit Care Med
Abstract
Introduction: Ankylosing spondylitis (AS) is a chronic seronegative inflammatory axial spondylitis that usually affects young males. Long-standing AS may lead to a restrictive pattern of pulmonary disease, likely due to chest wall and spinal immobility. However, the effect of AS on Obstructive Sleep Apnea (OSA) has been rarely described in the literature. We aimed to assess the association between the two diseases and to describe the morbidity outcomes in hospitalized patients with AS. Methods: Using the National Inpatient Sample (NIS) 2016-2020, we analyzed adult hospitalizations with and without AS using International Classification of Diseases - 10 Clinical Modification (ICD-10-CM) codes. The primary outcome was the association between AS and OSA. Secondary outcomes were inpatient mortality, effect on common comorbidities, mean length of stay (LOS), and mean total hospital charge (THC). Multivariate logistic regression and linear regression analyses were used to adjust for potential confounders. Results: Out of 88034 patients hospitalized with AS, 12.58% had OSA; 72% were males with a mean age of 63. While adjusting for obesity, smoking, acute and chronic respiratory conditions, and patients' characteristics, patients with AS had a 1.53 higher adjusted odds ratio (aOR) of having OSA with a 95% confidence interval (CI) of 1.46-1.62 and a p-value <0.001. Moreover, amongst patients with AS, patients with OSA had a higher risk of cardiac conduction abnormalities (aOR: 1.37, CI 1.11-1.70) and acute heart failure exacerbation (aOR: 1.63, CI: 1.36-1.95). Surprisingly, patients with AS and OSA had a lower chance of mortality (aOR: .59, CI: 0.41-0.84) and a lower chance of having acute coronary syndrome (aOR: 0.61, CI: 0.46-0.81). There was no statistically significant difference in LOS and THC. Figure 1 shows the Forrest plot for multivariate analysis of in-hospital morbidities when adjusted for patient demographics, comorbidities, and hospital characteristics. Conclusion: Patients with AS had higher odds of having OSA. Nevertheless, this has not impacted inpatient mortality and morbidity. This association should highlight the importance of screening for OSA in patients with AS. (Figure Presented).
Volume
209
