LIKELIHOOD OF PNEUMONIA IN ADULTS WITH OSA and CPAP USE
Abstract
Background
Chronic lung diseases (e.g., COPD, asthma) are recognized risk factors for pneumococcal disease, particularly pneumonia. Obstructive sleep apnea (OSA) is a prevalent chronic pulmonary disease in the US. This study evaluated whether OSA with continuous positive airway pressure (CPAP) or Bilevel positive airway pressure use may be an additional risk factor for pneumonia.
Methods
This study used records from the Optum-Humedica de-identified Electronic Health Record dataset from 01/2012-06/2018. Patients agedā„18 diagnosed with OSA with and without a procedure code indicating post-index CPAP were included. Logistic regression models adjusting for age, gender, region, calendar year, BMI and comorbidities were used to assess the association of CPAP with pneumonia within 1-year of OSA diagnosis by healthcare setting.
Results
Of 1,068,964 OSA patients, 36.3% used CPAP. Among the propensity score-matched groups, CPAP use was associated with increased risk of pneumonia [odds ratio(OR)=1.61, 95%CI=1.58-1.64]. Risk was highest in the inpatient setting (OR=1.95, 95%CI=1.90-1.99), and similar in the emergency department and outpatient settings (OR=1.55, 95%CI=1.49-1.61 and OR=1.51, 95%CI=1.47-1.55, respectively).
Conclusions
Preliminary results indicated CPAP use was associated with higher likelihood of pneumonia diagnosis. Identifying groups that may be at higher risk for pneumonia and potentially pneumococcal pneumonia is important given the growing incidence of OSA in the US.
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