Obstructive Sleep Apnea Is Associated with Worsened Hospital Outcomes in Children Hospitalized with Asthma

Abstract

Background: Studies have shown a bidirectional relationship between asthma and obstructive sleep apnea (OSA). However, there is a paucity of national-level data evaluating the impact of OSA on hospital outcomes in pediatric hospitalizations for asthma. Methods: We analyzed the National Inpatient Sample and Kids Inpatient Database to include all pediatric hospitalizations with a primary diagnosis of asthma between 2003–2016. Using ICD codes, the pediatric asthma cohort was divided into two groups: those with and those without a concomitant diagnosis of OSA. The primary outcomes were in-hospital mortality and the need for mechanical ventilation. The secondary outcomes were the lengths of each hospital stay and total hospitalization charges. Results: We analyzed 1,606,248 hospitalizations during the 14-year study period. The overall prevalence rate of OSA was 0.7%. Patients with asthma and OSA were significantly older (8.2 versus 5.9 years) and were more often male, p p p p p < 0.001) in hospitalization charges. Conclusion: OSA in children admitted with asthma is associated with poor hospital outcomes such as increased mortality risk, the need for mechanical ventilation, and increased healthcare utilization.

Keywords

• obstructive sleep apnea
• asthma
• population based analysis
• pediatric hopsitalization
• mortality
• mechanical ventilation