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PLoS One. 2015 Feb 11;10(2):e0117808. doi: 10.1371/journal.pone.0117808. eCollection 2015.

Obesity-hypoventilation syndrome: increased risk of death over sleep apnea syndrome.

Author information

1
Respiratory Division and Sleep Disorders Unit, Lucus Augusti University Hospital, Galician Health Service, Lugo, Spain.
2
Lucus Augusti University Hospital, Galician Health Service, Lugo, Spain.
3
Galician Health Service, Lugo, Spain.
4
Department of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.

Abstract

AIM:

To study whether mortality and cardiovascular morbidity differ in non-invasive ventilation (NIV)-treated patients with severe obesity-hypoventilation syndrome (OHS) as compared with CPAP-treated patients with obstructive sleep apnea syndrome (OSAS), and to identify independent predictors of mortality in OHS.

MATERIAL AND METHODS:

Two retrospective cohorts of OHS and OSAS were matched 1:2 according to sex, age (± 10 year) and length of time since initiation of CPAP/NIV therapy (± 6 months).

RESULTS:

Three hundred and thirty subjects (110 patients with OHS and 220 patients with OSAS) were studied. Mean follow-up time was 7 ± 4 years. The five year mortality rates were 15.5% in OHS cohort and 4.5% in OSAS cohort (p< 0.05). Patients with OHS had a 2-fold increase (OR 2; 95% CI: 1.11-3.60) in the risk of mortality and 1.86 fold (OR 1.86; 95% CI: 1.14-3.04) increased risk of having a cardiovascular event. Diabetes, baseline diurnal SaO2 < 83%, EPAP < 7 cmH2O after titration and adherence to NIV < 4 hours independently predicted mortality in OHS.

CONCLUSION:

Mortality of severe OHS is high and substantially worse than that of OSAS. Severe OHS should be considered a systemic disease that encompasses respiratory, metabolic and cardiovascular components that require a multimodal therapeutic approach.

PMID:
25671545
PMCID:
PMC4324970
DOI:
10.1371/journal.pone.0117808
[Indexed for MEDLINE]
Free PMC Article

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