Obstructive Lung Diseases: Airways 2 |

A Population Based Study of Prevalence of OSA in Patients With COPD: The Overlap Syndrome FREE TO VIEW

Amitesh Agarwal, MBBS; Wei Zhang, MS; Yong-Fang Kuo, PhD; Gulshan Sharma, MD
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UTMB, Galveston, TX

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):843A. doi:10.1016/j.chest.2016.08.943
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SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: There is growing evidence in the literature regarding the association of Chronic Obstructive Pulmonary Disease (COPD) and coexisting Obstructive Sleep Apnea (OSA) (termed as Overlap syndrome). The estimates of prevalence of OSA among patients with COPD are based on single center studies. There is no population based studies of overlap syndrome. Using 5% national sample of Medicare beneficiaries, we examined the prevalence and characteristics of patients with overlap syndrome from 2004 to 2011

METHODS: We analyzed data from 5% national sample of fee-for-service Medicare beneficiaries with diagnosis of COPD identified as any of the following: 1) at least two outpatient visits with an encounter diagnosis of COPD at least 30 days apart within a year; or 2) one acute care hospitalization with COPD diagnosis or listed in primary position as a discharge diagnosis. We defined patients having overlap syndrome if a new diagnosis of OSA is established by at least two outpatient claims for OSA based on ICD-9 codes in patients with COPD. We examined the trends in prevalence of overlap syndrome by each calendar year and determine the characteristics of patients with overlap syndrome.

RESULTS: Between 2004 and 2011, 134,752 patients with COPD were included. Of these 12,730 (9.4%) had coexisting OSA i.e. overlap syndrome. The prevalence of overlap syndrome in patients with COPD increased from 4.5% in 2004 to 10.5% in 2011 (p-value of trend <0.001). The largest increases in overlap syndrome during the study period was seen in age group 66-74 years, female gender, and those with 3 or more comorbidities. Patients with overlap syndrome had higher rates of obesity, hypertension, congestive heart failure, diabetes, hyperlipidemia and coronary artery disease compared to those with COPD alone.

CONCLUSIONS: 1 in 10 Medicare beneficiaries with COPD had overlap syndrome and the prevalence doubled during the study period.

CLINICAL IMPLICATIONS: Coexisting OSA is common in patients with COPD and those with overlap syndrome had a higher burden of cardiovascular comorbidities.

DISCLOSURE: The following authors have nothing to disclose: Amitesh Agarwal, Wei Zhang, Yong-Fang Kuo, Gulshan Sharma

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