Journal of investigative surgery : the official journal of the Academy of Surgical Research · 2026
Impact of COPD-OSA Overlap Syndrome on Outcomes of Total Hip Arthroplasty: A Propensity Score Analysis of the US National Inpatient Sample.
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Chen Chih-Hui, Chen Chiu-Liang, Li Yi-An, Lo Yu-Cheng
Аннотация
OBJECTIVES: Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) together is known as overlap syndrome. This study evaluated whether overlap syndrome is associated with worse inpatient outcomes after total hip arthroplasty (THA) compared with COPD alone.
METHODS: Adult patients (≥18 years) with COPD undergoing elective THA were identified from the National Inpatient Sample database. Propensity-score matching (PSM) balanced baseline differences between patients with COPD-OSA overlap syndrome and those with COPD alone. Regression analyses evaluated in-hospital mortality, length of hospital stay, unfavorable discharge, and postoperative complications.
RESULTS: After PSM, 25,926 patients were included. Compared with COPD alone, patients with COPD-OSA overlap had higher rates of unfavorable discharge (36.0% vs 29.7%), respiratory failure (3.6% vs 1.7%), and acute kidney injury (AKI) (6.3% vs 3.8%). In adjusted analyses, COPD-OSA overlap was significantly associated with higher risks of unfavorable discharge (aOR = 1.10, 95% CI: 1.03, 1.18), respiratory failure (aOR = 1.65, 95% CI: 1.37, 1.99), and AKI (aOR = 1.18, 95% CI: 1.03, 1.35). Age-stratified analyses demonstrated increased respiratory risk in patients ≥70 years, whereas younger patients had higher risks of both respiratory failure and AKI.
CONCLUSION: Among patients undergoing elective THA, COPD-OSA overlap syndrome is associated with increased adverse inpatient outcomes.
METHODS: Adult patients (≥18 years) with COPD undergoing elective THA were identified from the National Inpatient Sample database. Propensity-score matching (PSM) balanced baseline differences between patients with COPD-OSA overlap syndrome and those with COPD alone. Regression analyses evaluated in-hospital mortality, length of hospital stay, unfavorable discharge, and postoperative complications.
RESULTS: After PSM, 25,926 patients were included. Compared with COPD alone, patients with COPD-OSA overlap had higher rates of unfavorable discharge (36.0% vs 29.7%), respiratory failure (3.6% vs 1.7%), and acute kidney injury (AKI) (6.3% vs 3.8%). In adjusted analyses, COPD-OSA overlap was significantly associated with higher risks of unfavorable discharge (aOR = 1.10, 95% CI: 1.03, 1.18), respiratory failure (aOR = 1.65, 95% CI: 1.37, 1.99), and AKI (aOR = 1.18, 95% CI: 1.03, 1.35). Age-stratified analyses demonstrated increased respiratory risk in patients ≥70 years, whereas younger patients had higher risks of both respiratory failure and AKI.
CONCLUSION: Among patients undergoing elective THA, COPD-OSA overlap syndrome is associated with increased adverse inpatient outcomes.
Предметные рубрики MeSH
HumansArthroplasty, Replacement, HipFemaleAgedMalePropensity ScoreMiddle AgedPostoperative ComplicationsPulmonary Disease, Chronic ObstructiveUnited StatesLength of StayHospital MortalitySleep Apnea, ObstructiveRespiratory InsufficiencyRetrospective StudiesElective Surgical ProceduresAdultRisk FactorsTreatment OutcomePatient DischargeInpatients