0476 THE EPIDEMIOLOGY OF OBSTRUCTIVE SLEEP APNEA AND ASTHMA OR CHRONIC OBSTRUCTIVE PULMONARY DISEASE OVERLAP SYNDROMES IN ONTARIO, CANADA: A POPULATION-BASED COHORT STUDY
Notice bibliographique
Résumé
Despite their importance, the epidemiology of obstructive sleep apnea (OSA) and asthma (OSA/asthma), and OSA and chronic obstructive pulmonary disease (OSA/COPD) overlap syndromes have not been well studied. We conducted a population-based cohort study to estimate trends in the prevalence and mortality of individuals 35 years and older with OSA/asthma or OSA/COPD in Ontario, Canada. Ontario has a diverse population of about 13 million and a universal health care system that covers most medical services including polysomnography and positive airway pressure (PAP) treatment. Validated health administrative case definitions were used to identify individuals with moderate to severe asthma or COPD. Individuals with OSA were those who received OSA-related PAP treatment. Age- and sex-standardized annual prevalence and mortality rates were estimated and compared from 2009 to 2013 and between conditions. The highest prevalence for both overlaps was in those 50 to 79-years and men. The standardized prevalence increased from 2009 to 2013: for OSA/asthma from 0.38% to 0.54% of the population, for OSA/COPD from 0.23% to 0.31%. Both overlap syndromes were associated with higher mortality than OSA alone. Higher mortality was associated with OSA/asthma compared to asthma alone (OR = 1.09, 95%CI: 1.05–1.13) with larger differences in women and those younger than 50 years. In women but not men, a higher mortality was associated with OSA/COPD compared to COPD alone: OR = 1.06 (1.01–1.11). The standardized all-cause mortality rates among individuals with both overlap syndromes decreased modestly over time. In a large North American population, the prevalence of overlap syndromes was higher in men and middle-aged individuals, and increasing over time. Overlap syndromes were associated with excess mortality in spite of funded PAP treatment, particularly in women and younger people. These findings can alert health care providers and policy makers to the large and increasing burden of overlap syndromes and which high-risk groups are most affected. The Godfrey S Pettit Block Term Grants, University of Toronto; Canadian Respiratory Research Network fellowship training award; Institute for Clinical Evaluative Sciences, which is funded by an annual grant from the Ontario Ministry of Health and Long-term Care.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».