PREVALENCE AND PREDICTORS OF MAJOR ADVERSE CARDIAC AND CEREBROVASCULAR EVENTS IN GERIATRIC HOSPITALIZATIONS WITH OSA: A NATIONAL INPATIENT SAMPLE ANALYSIS

SESSION TITLE: Sleep and Sleep Apnea in Hospitalized PatientsSESSION TYPE: Original InvestigationsPRESENTED ON: 10/17/2022 1:30 pm - 2:30 pmPURPOSE: The risk of major cardiac and cerebrovascular events (MACCE) has been found to be high among obstructive sleep apnea (OSA) patients. However, contemporary large-scale population-based data for the burden and predictors of MACCE in geriatric patients with OSA (G-OSA) remains limited.METHODS: Using National Inpatient Sample (2018, ICD10 codes, age≥65 years), we identified G-OSA admissions and divided them into non-MACCE vs. MACCE (all-cause mortality, stroke, acute myocardial infarction, cardiac arrest). We compared the demographics and comorbidities in both cohorts and extracted the odds ratio (multivariate analysis) of MACCE and associated in-hospital mortality.RESULTS: Of 1,141,120 G-OSA admissions, 9.9% (113,295) had MACCE. Males vs. females, Asian or Pacific Islander/Native American vs. whites and patients from lowermost income quartile vs. highest income quartile revealed higher MACCE rate. The MACCE cohort was relatively older (median 74 vs 73 years) and a higher proportion of males (63.6 % vs. 57%) compared to non-MACCE cohorts. Significantly higher prevalence of CHF (27 vs 26.1%), hyperlipidemia (68 vs. 62.9%), diabetes mellitus (55.7 vs 49.7%), PVD (12.9 vs. 9.3%), prior MI (15.6 vs.11.1%), prior TIA/stroke (12.3 vs.10.6%), coagulopathy (10.7 vs 7%), renal failure (39.4 vs. 32.1%), pulmonary circulation disease (1.7 vs. 1.1%), deficiency anemias (25.2 vs 23.4%) fluid/electrolyte imbalance (39.4 vs 30.8%), alcohol abuse (2.1 vs 1.8%) were found in MACCE than non-MACCE cohort. Significant clinical predictors of MACCE in elderly OSA patients on multivariable regression analysis were found to be male sex (1.22 [1.18-1.26], vs females), low household income (1.19 [1.13-1.26], than high), diabetes (1.14 [1.10-1.17]), hyperlipidemia (1.20 [1.16-1.24]), peripheral vascular disease (1.34 [1.28-1.40]), renal failure (1.15 [1.12-1.19]), prior MI (1.27 [1.22-1.33]), prior TIA/stroke (1.12 [1.07-1.17]), prior SCA (1.34 [1.11-1.62]), valvular heart disease (1.11 [1.05-1.17]), pulmonary circulation disease (1.47 [1.31-1.66]), coagulopathy (1.43 [1.35-1.50]), metastatic cancer (1.14 [1.03-1.25]) and fluid and electrolyte disorders (1.25 [1.20-1.29]) (All p<0.05).CONCLUSIONS: MACCEs were seen in almost 1 out of every 10 G-OSA admissions. Male sex, Asian/Pacific Islander or Native American race, patients from low household income, with co-existent diabetes, hyperlipidemia, pulmonary and cardiovascular comorbidities independently predicted MACCE.CLINICAL IMPLICATIONS: High-risk G-OSA patients should be routinely screened for identified sociodemographic and comorbid risk factors for MACCE to improve outcomes and reduce healthcare costs.DISCLOSURES: No relevant relationships by Aditi BhanushaliNo relevant relationships by Harika Varma Chintalapalli PattaNo relevant relationships by Rupak DesaiNo relevant relationships by Sirisha GaraNo relevant relationships by Akhil JainNo relevant relationships by Neelima sai Lakshmi reddy KondapalliNo relevant relationships by Harleen MannNo relevant relationships by Mounika PusaNo relevant relationships by NAVYA SADUMNo relevant relationships by Qudsia SayyedaNo relevant relationships by Keerthi Sripathi SESSION TITLE: Sleep and Sleep Apnea in Hospitalized Patients SESSION TYPE: Original Investigations PRESENTED ON: 10/17/2022 1:30 pm - 2:30 pm PURPOSE: The risk of major cardiac and cerebrovascular events (MACCE) has been found to be high among obstructive sleep apnea (OSA) patients. However, contemporary large-scale population-based data for the burden and predictors of MACCE in geriatric patients with OSA (G-OSA) remains limited. METHODS: Using National Inpatient Sample (2018, ICD10 codes, age≥65 years), we identified G-OSA admissions and divided them into non-MACCE vs. MACCE (all-cause mortality, stroke, acute myocardial infarction, cardiac arrest). We compared the demographics and comorbidities in both cohorts and extracted the odds ratio (multivariate analysis) of MACCE and associated in-hospital mortality. RESULTS: Of 1,141,120 G-OSA admissions, 9.9% (113,295) had MACCE. Males vs. females, Asian or Pacific Islander/Native American vs. whites and patients from lowermost income quartile vs. highest income quartile revealed higher MACCE rate. The MACCE cohort was relatively older (median 74 vs 73 years) and a higher proportion of males (63.6 % vs. 57%) compared to non-MACCE cohorts. Significantly higher prevalence of CHF (27 vs 26.1%), hyperlipidemia (68 vs. 62.9%), diabetes mellitus (55.7 vs 49.7%), PVD (12.9 vs. 9.3%), prior MI (15.6 vs.11.1%), prior TIA/stroke (12.3 vs.10.6%), coagulopathy (10.7 vs 7%), renal failure (39.4 vs. 32.1%), pulmonary circulation disease (1.7 vs. 1.1%), deficiency anemias (25.2 vs 23.4%) fluid/electrolyte imbalance (39.4 vs 30.8%), alcohol abuse (2.1 vs 1.8%) were found in MACCE than non-MACCE cohort. Significant clinical predictors of MACCE in elderly OSA patients on multivariable regression analysis were found to be male sex (1.22 [1.18-1.26], vs females), low household income (1.19 [1.13-1.26], than high), diabetes (1.14 [1.10-1.17]), hyperlipidemia (1.20 [1.16-1.24]), peripheral vascular disease (1.34 [1.28-1.40]), renal failure (1.15 [1.12-1.19]), prior MI (1.27 [1.22-1.33]), prior TIA/stroke (1.12 [1.07-1.17]), prior SCA (1.34 [1.11-1.62]), valvular heart disease (1.11 [1.05-1.17]), pulmonary circulation disease (1.47 [1.31-1.66]), coagulopathy (1.43 [1.35-1.50]), metastatic cancer (1.14 [1.03-1.25]) and fluid and electrolyte disorders (1.25 [1.20-1.29]) (All p<0.05). CONCLUSIONS: MACCEs were seen in almost 1 out of every 10 G-OSA admissions. Male sex, Asian/Pacific Islander or Native American race, patients from low household income, with co-existent diabetes, hyperlipidemia, pulmonary and cardiovascular comorbidities independently predicted MACCE. CLINICAL IMPLICATIONS: High-risk G-OSA patients should be routinely screened for identified sociodemographic and comorbid risk factors for MACCE to improve outcomes and reduce healthcare costs. DISCLOSURES: No relevant relationships by Aditi Bhanushali No relevant relationships by Harika Varma Chintalapalli Patta No relevant relationships by Rupak Desai No relevant relationships by Sirisha Gara No relevant relationships by Akhil Jain No relevant relationships by Neelima sai Lakshmi reddy Kondapalli No relevant relationships by Harleen Mann No relevant relationships by Mounika Pusa No relevant relationships by NAVYA SADUM No relevant relationships by Qudsia Sayyeda No relevant relationships by Keerthi Sripathi