Obstructive sleep apnea (OSA) is not uncommon in hospitalized patients with heart failure and is an independent risk factor for readmission. But it is unclear what the association is between undiagnosed OSA in these patients and costs for a healthcare system. A study presented as part of the CHEST Annual Meeting 2020 found that previously undiagnosed OSA in hospitalized patients with heart failure resulted in increased readmissions and costs at three and six months.
Hospitalized patients with heart failure who underwent inpatient sleep testing during the index hospitalization (n=1,547) were eligible for inclusion. Cost, number of readmissions, and vitals were tracked post-discharge. A total of 716 patients had OSA, and 393 had no sleep disordered breathing (SDB).
The OSA group, compared with the no SDB group, had higher rates of three- (27.1% vs. 20.4%; P=0.01) and six-month readmission (36.9% vs. 27.7%; P=0.002).
In adjusted analyses, among patients who required readmission, at three months, the estimated cumulative costs of readmissions were $9,792 for the OSA group compared with $5,846 for the no SBD group (P=0.03). At six months, the estimated cumulative costs were $16,180 and $8,719 in the OSA and no SBD groups, respectively (P<0.001).
“Healthcare systems attempting to identify high prevalence and high-cost patient populations for targeted readmission reduction efforts can consider interventions in previously undiagnosed OSA patients during decompensated heart failure admissions,” the study authors stated.