Key result
Obstructive sleep apnea was not independently associated with 30-day all-cause readmission following hospitalization for acute decompensated HFpEF (adjusted OR 0.92; 95% CI 0.77-1.09).
Why the study?
The independent impact of obstructive sleep apnea on short-term readmission and in-hospital outcomes among hospitalizations with HFpEF was poorly characterized.
Does obstructive sleep apnea increase 30-day all-cause readmission in adult hospitalizations with acute decompensated HFpEF?
Cohort
Yes
Does obstructive sleep apnea increase 30-day all-cause readmission in adult hospitalizations with acute decompensated HFpEF?
Obstructive sleep apnea is not independently associated with increased 30-day readmission risk in patients hospitalized with acute decompensated HFpEF, with adverse outcomes primarily driven by acute illness severity.
OSA in HFpEF hospitalizations linked to high readmission and costs; leaves open whether OSA screening or treatment improves outcomes.
BACKGROUND: Obstructive sleep apnea (OSA) is highly prevalent among patients with heart failure with preserved ejection fraction (HFpEF). The aim of this study was to analyze the poorly characterized independent impact of OSA on short-term readmission and in-hospital outcomes among hospitalizations with HFpEF. METHODS: We performed a retrospective cohort study using the 2019 Nationwide Readmission Database. Adult hospitalizations with acute decompensated HFpEF were identified using ICD-10 codes, and OSA was defined using secondary ICD-10 codes during the index hospitalization. The primary outcome was 30-day all-cause readmission following index hospitalization. Secondary outcomes included length of stay, total hospital charges, days to readmission, and in-hospital mortality. Survey-weighted multivariable logistic and linear regression models were utilized. OSA was not independently associated with readmission after adjustment (adjusted odds ratio 0.92, 95% confidence interval 0.77-1.09). Among readmitted patients, those with OSA had higher renal and respiratory complications, while comorbidity burden, payer mix, income quartile, and hospital characteristics were otherwise comparable. The most common readmission diagnosis in the OSA group was hypertensive heart disease. OSA was also not associated with index length of stay, total charges, time to readmission, or in-hospital mortality. Adverse outcomes were noted to be primarily driven by illness severity and resource intensity. CONCLUSION: The national prevalence of OSA is approximately 32% and noted to be higher in heart failure patients. Our study depicted a prevalence of 17%, which may be associated with underuse of the code. Readmission risk and resource utilization were driven by acute illness severity and need for organ support, highlighting the importance of targeting inpatient complications to reduce early HFpEF readmissions.
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Peesapati et al. (2026) conducted a cohort in Heart failure with preserved ejection fraction (HFpEF). Obstructive sleep apnea (OSA) vs. Without OSA was evaluated on 30-day all-cause readmission following index hospitalization (adjusted OR 0.92, 95% CI 0.77-1.09, p=0.82). Obstructive sleep apnea was not independently associated with 30-day all-cause readmission following hospitalization for acute decompensated HFpEF (adjusted OR 0.92; 95% CI 0.77-1.09).
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