The role of obstructive sleep apnea on the prognosis of pulmonary embolism: a systemic review and meta-analysis
Purpose The relationship between obstructive sleep apnea (OSA) and pulmonary embolism (PE) has been reported by some studies but the underlying mechanism remains unclear. We aimed to systematically assess the role of OSA on the disease prognosis of PE. Methods We searched for studies on the relation...
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| Veröffentlicht in: | Sleep & breathing 2021-09, Vol.25 (3), p.1419-1426 |
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| creator | Xu, Jiahuan Wang, Xingjian Meng, Fanqi Zhao, Tian Tang, Tingyu Wu, Wenjuan Wang, Wei |
| description | Purpose
The relationship between obstructive sleep apnea (OSA) and pulmonary embolism (PE) has been reported by some studies but the underlying mechanism remains unclear. We aimed to systematically assess the role of OSA on the disease prognosis of PE.
Methods
We searched for studies on the relationship of OSA and the prognosis of PE published up to February 2020 among PubMed, Web of Science, EMBASE, and Cochrane Library databases. Two independent reviewers conducted the process of study search and screening, quality assessment, and data extraction. Meta-analysis was carried out using RevMan 5.3.
Results
A total of 9 articles were included, and the funnel plots suggested no evidence of publication bias among studies. The results showed that compared to PE patients without OSA, the PE patients with moderate-severe OSA were more likely to be high-risk type (OR = 1.96, 95% CI [1.14, 3.34]) and with higher index of disease severity (sPESI: OR = 2.29, 95% CI [1.50, 3.47]; PAOI%: MD = 13.52, 95% CI [7.2, 19.83]). The prevalence of recurrent PE was higher in PE patients with OSA than those without OSA (RR = 3.87, 95% CI [1.65, 9.07]). However, there was no significant difference in right ventricle to left ventricle short-axis diameter (MD = 0.08, 95% CI [− 0.06, 0.21]), length of hospital stay (MD = 1.03, 95% CI [− 1.11, 3.17]), or prevalence of deep vein thrombosis (OR = 0.87, 95% CI [0.48, 1.57]). Sensitivity and subgroup analysis showed that the pooled outcomes were stable.
Conclusion
OSA, especially moderate-severe OSA, was a risk factor for high-risk PE and recurrent PE. However, the current evidence showed that the length of hospital stay is not influenced by OSA. |
| doi_str_mv | 10.1007/s11325-020-02258-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2464187520</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2464187520</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-84238bd38aef41c26d4b5d5ca667bfb6d12cab86a13e749aadf3a7c0d33ead643</originalsourceid><addsrcrecordid>eNp9kUtr3DAUhUVpaCaPP9BFEXSTjRM9bNnTXQl5wUA2yVpcS9epg205unbCzK-vZiZNoYsuhAT6ztHVOYx9leJcClFekJRaFZlQIi1VVNnmE1vIQqlMlmL5eXcW2bKQ6pAdET0LIfNqKb-wQ62VNkroBQsPv5DH0CEPDQ81TXF2U_uKnDrEkcM4IPAw8ClhYwxPQ6CWtuw4d30YIK459nXoWup_cOC0pgn71vGIry2-cRg873GCDAbo1kl6wg4a6AhP3_dj9nh99XB5m63ub-4uf64yp8tiyqpc6ar2ugJscumU8Xld-MKBMWXd1MZL5aCuDEiNZb4E8I2G0gmvNYI3uT5mZ3vfNPTLjDTZviWHXQcDhpmsyk0uqzIFlNDv_6DPYY5p3kQVRpmUX7ml1J5yMRBFbOwY2z7930pht3XYfR021WF3ddhNEn17t57rHv2H5E_-CdB7gNLV8ITx79v_sf0NYB-XjQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2562651270</pqid></control><display><type>article</type><title>The role of obstructive sleep apnea on the prognosis of pulmonary embolism: a systemic review and meta-analysis</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Xu, Jiahuan ; Wang, Xingjian ; Meng, Fanqi ; Zhao, Tian ; Tang, Tingyu ; Wu, Wenjuan ; Wang, Wei</creator><creatorcontrib>Xu, Jiahuan ; Wang, Xingjian ; Meng, Fanqi ; Zhao, Tian ; Tang, Tingyu ; Wu, Wenjuan ; Wang, Wei</creatorcontrib><description>Purpose
The relationship between obstructive sleep apnea (OSA) and pulmonary embolism (PE) has been reported by some studies but the underlying mechanism remains unclear. We aimed to systematically assess the role of OSA on the disease prognosis of PE.
Methods
We searched for studies on the relationship of OSA and the prognosis of PE published up to February 2020 among PubMed, Web of Science, EMBASE, and Cochrane Library databases. Two independent reviewers conducted the process of study search and screening, quality assessment, and data extraction. Meta-analysis was carried out using RevMan 5.3.
Results
A total of 9 articles were included, and the funnel plots suggested no evidence of publication bias among studies. The results showed that compared to PE patients without OSA, the PE patients with moderate-severe OSA were more likely to be high-risk type (OR = 1.96, 95% CI [1.14, 3.34]) and with higher index of disease severity (sPESI: OR = 2.29, 95% CI [1.50, 3.47]; PAOI%: MD = 13.52, 95% CI [7.2, 19.83]). The prevalence of recurrent PE was higher in PE patients with OSA than those without OSA (RR = 3.87, 95% CI [1.65, 9.07]). However, there was no significant difference in right ventricle to left ventricle short-axis diameter (MD = 0.08, 95% CI [− 0.06, 0.21]), length of hospital stay (MD = 1.03, 95% CI [− 1.11, 3.17]), or prevalence of deep vein thrombosis (OR = 0.87, 95% CI [0.48, 1.57]). Sensitivity and subgroup analysis showed that the pooled outcomes were stable.
Conclusion
OSA, especially moderate-severe OSA, was a risk factor for high-risk PE and recurrent PE. However, the current evidence showed that the length of hospital stay is not influenced by OSA.</description><identifier>ISSN: 1520-9512</identifier><identifier>EISSN: 1522-1709</identifier><identifier>DOI: 10.1007/s11325-020-02258-z</identifier><identifier>PMID: 33236203</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Apnea ; Dentistry ; Embolism ; Humans ; Internal Medicine ; Length of stay ; Medicine ; Medicine & Public Health ; Meta-analysis ; Neurology ; Otorhinolaryngology ; Patients ; Pediatrics ; Pneumology/Respiratory System ; Prevalence ; Prognosis ; Pulmonary Embolism - epidemiology ; Pulmonary Embolism - therapy ; Pulmonary embolisms ; Quality control ; Recurrence ; Risk Factors ; Severity of Illness Index ; Sleep ; Sleep apnea ; Sleep Apnea, Obstructive - epidemiology ; Sleep Breathing Physiology and Disorders • Original Article ; Sleep disorders ; Systematic review ; Thrombosis ; Ventricle</subject><ispartof>Sleep & breathing, 2021-09, Vol.25 (3), p.1419-1426</ispartof><rights>Springer Nature Switzerland AG 2020</rights><rights>2020. Springer Nature Switzerland AG.</rights><rights>Springer Nature Switzerland AG 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-84238bd38aef41c26d4b5d5ca667bfb6d12cab86a13e749aadf3a7c0d33ead643</citedby><cites>FETCH-LOGICAL-c375t-84238bd38aef41c26d4b5d5ca667bfb6d12cab86a13e749aadf3a7c0d33ead643</cites><orcidid>0000-0003-3454-966X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11325-020-02258-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11325-020-02258-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33236203$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Xu, Jiahuan</creatorcontrib><creatorcontrib>Wang, Xingjian</creatorcontrib><creatorcontrib>Meng, Fanqi</creatorcontrib><creatorcontrib>Zhao, Tian</creatorcontrib><creatorcontrib>Tang, Tingyu</creatorcontrib><creatorcontrib>Wu, Wenjuan</creatorcontrib><creatorcontrib>Wang, Wei</creatorcontrib><title>The role of obstructive sleep apnea on the prognosis of pulmonary embolism: a systemic review and meta-analysis</title><title>Sleep & breathing</title><addtitle>Sleep Breath</addtitle><addtitle>Sleep Breath</addtitle><description>Purpose
The relationship between obstructive sleep apnea (OSA) and pulmonary embolism (PE) has been reported by some studies but the underlying mechanism remains unclear. We aimed to systematically assess the role of OSA on the disease prognosis of PE.
Methods
We searched for studies on the relationship of OSA and the prognosis of PE published up to February 2020 among PubMed, Web of Science, EMBASE, and Cochrane Library databases. Two independent reviewers conducted the process of study search and screening, quality assessment, and data extraction. Meta-analysis was carried out using RevMan 5.3.
Results
A total of 9 articles were included, and the funnel plots suggested no evidence of publication bias among studies. The results showed that compared to PE patients without OSA, the PE patients with moderate-severe OSA were more likely to be high-risk type (OR = 1.96, 95% CI [1.14, 3.34]) and with higher index of disease severity (sPESI: OR = 2.29, 95% CI [1.50, 3.47]; PAOI%: MD = 13.52, 95% CI [7.2, 19.83]). The prevalence of recurrent PE was higher in PE patients with OSA than those without OSA (RR = 3.87, 95% CI [1.65, 9.07]). However, there was no significant difference in right ventricle to left ventricle short-axis diameter (MD = 0.08, 95% CI [− 0.06, 0.21]), length of hospital stay (MD = 1.03, 95% CI [− 1.11, 3.17]), or prevalence of deep vein thrombosis (OR = 0.87, 95% CI [0.48, 1.57]). Sensitivity and subgroup analysis showed that the pooled outcomes were stable.
Conclusion
OSA, especially moderate-severe OSA, was a risk factor for high-risk PE and recurrent PE. However, the current evidence showed that the length of hospital stay is not influenced by OSA.</description><subject>Apnea</subject><subject>Dentistry</subject><subject>Embolism</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Length of stay</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Neurology</subject><subject>Otorhinolaryngology</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Pneumology/Respiratory System</subject><subject>Prevalence</subject><subject>Prognosis</subject><subject>Pulmonary Embolism - epidemiology</subject><subject>Pulmonary Embolism - therapy</subject><subject>Pulmonary embolisms</subject><subject>Quality control</subject><subject>Recurrence</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>Sleep</subject><subject>Sleep apnea</subject><subject>Sleep Apnea, Obstructive - epidemiology</subject><subject>Sleep Breathing Physiology and Disorders • Original Article</subject><subject>Sleep disorders</subject><subject>Systematic review</subject><subject>Thrombosis</subject><subject>Ventricle</subject><issn>1520-9512</issn><issn>1522-1709</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kUtr3DAUhUVpaCaPP9BFEXSTjRM9bNnTXQl5wUA2yVpcS9epg205unbCzK-vZiZNoYsuhAT6ztHVOYx9leJcClFekJRaFZlQIi1VVNnmE1vIQqlMlmL5eXcW2bKQ6pAdET0LIfNqKb-wQ62VNkroBQsPv5DH0CEPDQ81TXF2U_uKnDrEkcM4IPAw8ClhYwxPQ6CWtuw4d30YIK459nXoWup_cOC0pgn71vGIry2-cRg873GCDAbo1kl6wg4a6AhP3_dj9nh99XB5m63ub-4uf64yp8tiyqpc6ar2ugJscumU8Xld-MKBMWXd1MZL5aCuDEiNZb4E8I2G0gmvNYI3uT5mZ3vfNPTLjDTZviWHXQcDhpmsyk0uqzIFlNDv_6DPYY5p3kQVRpmUX7ml1J5yMRBFbOwY2z7930pht3XYfR021WF3ddhNEn17t57rHv2H5E_-CdB7gNLV8ITx79v_sf0NYB-XjQ</recordid><startdate>20210901</startdate><enddate>20210901</enddate><creator>Xu, Jiahuan</creator><creator>Wang, Xingjian</creator><creator>Meng, Fanqi</creator><creator>Zhao, Tian</creator><creator>Tang, Tingyu</creator><creator>Wu, Wenjuan</creator><creator>Wang, Wei</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7T5</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>88J</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2R</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3454-966X</orcidid></search><sort><creationdate>20210901</creationdate><title>The role of obstructive sleep apnea on the prognosis of pulmonary embolism: a systemic review and meta-analysis</title><author>Xu, Jiahuan ; Wang, Xingjian ; Meng, Fanqi ; Zhao, Tian ; Tang, Tingyu ; Wu, Wenjuan ; Wang, Wei</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-84238bd38aef41c26d4b5d5ca667bfb6d12cab86a13e749aadf3a7c0d33ead643</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Apnea</topic><topic>Dentistry</topic><topic>Embolism</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Length of stay</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Neurology</topic><topic>Otorhinolaryngology</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Pneumology/Respiratory System</topic><topic>Prevalence</topic><topic>Prognosis</topic><topic>Pulmonary Embolism - epidemiology</topic><topic>Pulmonary Embolism - therapy</topic><topic>Pulmonary embolisms</topic><topic>Quality control</topic><topic>Recurrence</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>Sleep</topic><topic>Sleep apnea</topic><topic>Sleep Apnea, Obstructive - epidemiology</topic><topic>Sleep Breathing Physiology and Disorders • Original Article</topic><topic>Sleep disorders</topic><topic>Systematic review</topic><topic>Thrombosis</topic><topic>Ventricle</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Xu, Jiahuan</creatorcontrib><creatorcontrib>Wang, Xingjian</creatorcontrib><creatorcontrib>Meng, Fanqi</creatorcontrib><creatorcontrib>Zhao, Tian</creatorcontrib><creatorcontrib>Tang, Tingyu</creatorcontrib><creatorcontrib>Wu, Wenjuan</creatorcontrib><creatorcontrib>Wang, Wei</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Social Science Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Social Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Sleep & breathing</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Xu, Jiahuan</au><au>Wang, Xingjian</au><au>Meng, Fanqi</au><au>Zhao, Tian</au><au>Tang, Tingyu</au><au>Wu, Wenjuan</au><au>Wang, Wei</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The role of obstructive sleep apnea on the prognosis of pulmonary embolism: a systemic review and meta-analysis</atitle><jtitle>Sleep & breathing</jtitle><stitle>Sleep Breath</stitle><addtitle>Sleep Breath</addtitle><date>2021-09-01</date><risdate>2021</risdate><volume>25</volume><issue>3</issue><spage>1419</spage><epage>1426</epage><pages>1419-1426</pages><issn>1520-9512</issn><eissn>1522-1709</eissn><abstract>Purpose
The relationship between obstructive sleep apnea (OSA) and pulmonary embolism (PE) has been reported by some studies but the underlying mechanism remains unclear. We aimed to systematically assess the role of OSA on the disease prognosis of PE.
Methods
We searched for studies on the relationship of OSA and the prognosis of PE published up to February 2020 among PubMed, Web of Science, EMBASE, and Cochrane Library databases. Two independent reviewers conducted the process of study search and screening, quality assessment, and data extraction. Meta-analysis was carried out using RevMan 5.3.
Results
A total of 9 articles were included, and the funnel plots suggested no evidence of publication bias among studies. The results showed that compared to PE patients without OSA, the PE patients with moderate-severe OSA were more likely to be high-risk type (OR = 1.96, 95% CI [1.14, 3.34]) and with higher index of disease severity (sPESI: OR = 2.29, 95% CI [1.50, 3.47]; PAOI%: MD = 13.52, 95% CI [7.2, 19.83]). The prevalence of recurrent PE was higher in PE patients with OSA than those without OSA (RR = 3.87, 95% CI [1.65, 9.07]). However, there was no significant difference in right ventricle to left ventricle short-axis diameter (MD = 0.08, 95% CI [− 0.06, 0.21]), length of hospital stay (MD = 1.03, 95% CI [− 1.11, 3.17]), or prevalence of deep vein thrombosis (OR = 0.87, 95% CI [0.48, 1.57]). Sensitivity and subgroup analysis showed that the pooled outcomes were stable.
Conclusion
OSA, especially moderate-severe OSA, was a risk factor for high-risk PE and recurrent PE. However, the current evidence showed that the length of hospital stay is not influenced by OSA.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>33236203</pmid><doi>10.1007/s11325-020-02258-z</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-3454-966X</orcidid></addata></record> |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Apnea Dentistry Embolism Humans Internal Medicine Length of stay Medicine Medicine & Public Health Meta-analysis Neurology Otorhinolaryngology Patients Pediatrics Pneumology/Respiratory System Prevalence Prognosis Pulmonary Embolism - epidemiology Pulmonary Embolism - therapy Pulmonary embolisms Quality control Recurrence Risk Factors Severity of Illness Index Sleep Sleep apnea Sleep Apnea, Obstructive - epidemiology Sleep Breathing Physiology and Disorders • Original Article Sleep disorders Systematic review Thrombosis Ventricle |
| title | The role of obstructive sleep apnea on the prognosis of pulmonary embolism: a systemic review and meta-analysis |
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