Obstructive Sleep Apnea Is Associated With Lower Mortality, AKI, and Cardiogenic Shock in SVT Hospitalizations: Insights From the National Inpatient Sample
Dua Malik, DO, Henry Ford Warren Hospital, Warren, MI
Ider Oujamaa, MD, Henry Ford Warren Hospital, Madison Heights, MI, Mohammad Ali Sheffeh, MD, Henry Ford Warren Hospital, Sterling Heights, MI, Dua Malik, DO, Henry Ford Warren Hospital, Warren, MI, Yassine Hamdaoui, MD, Henry Ford St John Hospital, Detroit, MI, Muhammad Syed, DO, Henry Ford Genesys Hospital, Grand Blanc, MI, Naveen Vuppuluri, DO, Henry Ford Health System, Novi, MI, Amanda P Rawson, DO, Henry Ford Warren Hospital, Chesterfield, MI, Zarghoona Wajid, MD, Wayne State University, Rochester Hills, MI, Raj K Patel, DO, Henry Ford-Warren, Warren, MI and Jelena Z. Arnautovic, DO, FSCAI, Henry Ford Warren Hospital, Macomb, MI
Background:
Obstructive sleep apnea (OSA) has been linked to adverse cardiovascular outcomes, but its impact in patients hospitalized with supraventricular tachycardia (SVT) is unclear. We examined whether OSA influences in-hospital outcomes among adults admitted with SVT.
Methods:
Using the National Inpatient Sample (2018–2021), we identified adult SVT hospitalizations. The exposure was coded OSA. The primary outcome was in-hospital mortality; secondary outcomes included acute kidney injury (AKI), cardiogenic shock, pericardial effusion, cardiac arrest, ventricular tachycardia/fibrillation (VT/VF), mechanical ventilation, transfusion, permanent pacemaker implantation, catheter ablation, length of stay (LOS), and charges. OSA and non-OSA admissions were propensity-score matched 1:2, balancing demographics, hospital features, and comorbidities. Weighted logistic regression and generalized linear models were applied post-match.
Results:
The cohort included 144,295 weighted SVT hospitalizations (mean age 64 y; 53.5% female). After matching, 3,421 OSA admissions were compared with 6,332 controls. OSA was associated with lower odds of mortality (OR 0.46, 95% CI 0.23–0.93; p = 0.031), AKI (OR 0.82, 95% CI 0.73–0.93; p = 0.001), and cardiogenic shock (OR 0.58, 95% CI 0.38–0.91; p = 0.016). No significant associations were found with pericardial effusion, cardiac arrest, VT/VF, mechanical ventilation, transfusion, pacemaker implantation, or catheter ablation. LOS and charges were similar.
Conclusions:
In this nationwide propensity-matched study, OSA was paradoxically associated with lower mortality, AKI, and cardiogenic shock among SVT admissions, with no differences in other complications or resource use. This may reflect underdiagnosis bias or physiologic adaptation to chronic hypoxia. Further studies are needed to clarify mechanisms.