在第一次终止后恢复CPAP和对法国所有原因死亡率的影响
Jean-Louis Pépin1, Renaud Tamisier2, Adam V Benjafield3
1University Grenoble Alpes, Inserm, CHU Grenoble Alpes, HP2, Grenoble, France JPepin@chu-grenoble.fr.
The European respiratory journal
|December 22, 2023
概括
恢复阻塞性睡眠呼吸暂停 (OSA) 的持续正气道压力 (CPAP) 治疗可以显著降低死亡风险. 对于最初停止治疗的患者,建议进行第二次CPAP试验,因为许多人将继续治疗并受益.
科学领域:
- 睡眠医学 睡眠医学
- 呼吸系统医学 呼吸系统医学
- 公共卫生 公共卫生
背景情况:
- 持续的正气道压力 (CPAP) 治疗对于管理阻塞性睡眠呼吸暂停 (OSA) 至关重要.
- 虽然CPAP的延续降低了死亡率,但最初终止后恢复治疗的数据有限.
- 这项研究调查了CPAP恢复率,预测因素和OSA患者的死亡率影响.
研究的目的:
- 为了确定CPAP在治疗结束后一年内恢复的患病率.
- 确定影响CPAP在第二次试验后继续使用的因素.
- 评估CPAP恢复对OSA患者全因死亡率的影响.
主要方法:
- 对法国成年人 (≥18岁) 的国民医疗保险退款数据的分析.
- 使用特定治疗代码识别CPAP处方.
- 将恢复并继续CPAP治疗一年的患者与恢复并再次终止治疗的患者匹配.
主要成果:
- 26%的患者在第一次终止后12个月内恢复CPAP;其中65%的患者继续使用一年.
- 男性性别,高血压和肺部医生的处方预测了CPAP的延续.
- 在恢复后继续CPAP,与第二次停药相比,所有死因的死亡风险降低了38% (HR 0.62).
结论:
- 在最初的终止后,很大一部分OSA患者恢复CPAP治疗.
- 成功恢复CPAP与降低死亡率有关.
- 应向最初治疗失败的患者提供第二次CPAP试验.
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