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Deep Neck Infection Risk in Patients with Sleep Apnea: Real-World Evidence

Author

Listed:
  • Meng-Chang Ding

    (Department of Otolaryngology–Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan)

  • Cheng-Ming Hsu

    (Department of Otolaryngology–Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
    College of Medicine, Chang Gung University, Taoyuan 333, Taiwan)

  • Stanley Yung-Chuan Liu

    (Division of Sleep Surgery, Department of Otolaryngology–Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA)

  • Yi-Chan Lee

    (College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
    Department of Otolaryngology–Head and Neck Surgery, Keelung Chang Gung Memorial Hospital, Keelung 204, Taiwan)

  • Yao-Hsu Yang

    (College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
    Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
    Department of Traditional Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan)

  • Chia-Yen Liu

    (Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan)

  • Geng-He Chang

    (Department of Otolaryngology–Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
    College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
    Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
    Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan)

  • Yao-Te Tsai

    (Department of Otolaryngology–Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
    College of Medicine, Chang Gung University, Taoyuan 333, Taiwan)

  • Li-Ang Lee

    (College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
    Department of Otolaryngology–Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan)

  • Pei-Rung Yang

    (College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
    Department of Traditional Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan)

  • Hsueh-Yu Li

    (College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
    Department of Otolaryngology–Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan)

  • Ming-Shao Tsai

    (Department of Otolaryngology–Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
    College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
    Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
    Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan)

Abstract

(1) Background: Sleep apnea may be a risk factor for deep neck infection (DNI). The objective of this study was to investigate the effects of sleep apnea on DNI. (2) Methods: In this first nationwide retrospective cohort study on the sleep apnea–DNI correlation, we obtained data from the Longitudinal Health Insurance Database 2005, a subset of the Taiwan National Health Insurance Research Database. Patients who were newly diagnosed with sleep apnea between 1997 and 2012 were identified, and patients without sleep apnea were matched at a 1:4 ratio in age, sex, socioeconomic status, and urbanization level. The primary outcome of this study was DNI occurrence. The treatment modalities for sleep apnea and the comorbidities that occurred during the study period were also analyzed. (3) Results: Our sleep apnea and comparison (non-sleep apnea) cohorts comprised 6114 and 24,456 patients, respectively. We compared the cumulative incidence of DNI between these cohorts and found a greater incidence of DNI in the sleep apnea cohort ( p < 0.001). A strong sleep apnea–DNI association was found following analysis via the adjusted Cox proportional-hazards model (full model hazard ratio, 1.71; 95% confidence interval, 1.28–2.28; p < 0.001). In the subgroup analysis, sleep apnea increased DNI risk in men, in those aged < 50 years, and in those without diabetes mellitus, end-stage renal disease, liver cirrhosis, autoimmune disease, obesity, tonsillectomy, or adenotonsillectomy. (4) Conclusions: Our results confirmed sleep apnea to be an independent risk factor for DNI. Physicians should be aware of the potential occurrence of DNI in patients with sleep apnea.

Suggested Citation

  • Meng-Chang Ding & Cheng-Ming Hsu & Stanley Yung-Chuan Liu & Yi-Chan Lee & Yao-Hsu Yang & Chia-Yen Liu & Geng-He Chang & Yao-Te Tsai & Li-Ang Lee & Pei-Rung Yang & Hsueh-Yu Li & Ming-Shao Tsai, 2021. "Deep Neck Infection Risk in Patients with Sleep Apnea: Real-World Evidence," IJERPH, MDPI, vol. 18(6), pages 1-10, March.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:6:p:3191-:d:520480
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    References listed on IDEAS

    as
    1. Chi-Shin Wu & Mei-Shu Lai & Susan Shur-Fen Gau & Sheng-Chang Wang & Hui-Ju Tsai, 2014. "Concordance between Patient Self-Reports and Claims Data on Clinical Diagnoses, Medication Use, and Health System Utilization in Taiwan," PLOS ONE, Public Library of Science, vol. 9(12), pages 1-16, December.
    2. Ming-Shao Tsai & Geng-He Chang & Wei-Ming Chen & Chia-Yen Liu & Meng-Hung Lin & Pey-Jium Chang & Tsung-Yu Huang & Yao-Te Tsai & Ching-Yuan Wu & Cheng-Ming Hsu & Yao-Hsu Yang, 2019. "The Association Between Decompensated Liver Cirrhosis and Deep Neck Infection: Real-World Evidence," IJERPH, MDPI, vol. 16(20), pages 1-11, October.
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