1052 Impact of CPAP Adherence on Hospitalized Patients Diagnosed with OSA on Healthcare Utilization in Rural Settings

Abstract Introduction Obstructive Sleep Apnea (OSA) is an increasingly prevalent condition with significant implications for cardiopulmonary health. Data suggests that early detection of OSA in hospitalized patients may improve outcomes. However, the effects of CPAP therapy have not been studied for hospitalized patients in a rural population. The primary purpose of this study is to examine the 1-year readmission, ED visit rate, and associated healthcare costs in hospitalized patients screened as high-risk for OSA, diagnosed, and started on CPAP therapy. Methods Through a retrospective review of 2042 patients from 08/2019 to 06/2023 in a registry of a hospital-based sleep medicine program, 786 patients were determined as high risk based on their results from apnea link. From there, 341 patients were selected based on their completion of an outpatient polysomnography (PSG), of which 293 were assessed for adherence of CPAP therapy. Composite end point of combined number of hospitalization and emergency department (ED) visits for 1-year were recorded, further separating the outcomes that were cardiopulmonary in nature due to the CPAP’s focus on those organs. Moreover, cost analysis was performed. Results Of the 293 assessed for adherence of CPAP therapy, 108 patients were adherent, while 185 were non-adherent. The mean age of patients evaluated was 58 years (12.82) and 57% were males. The average BMI of these patients was 39.7 (10.7). The mean AHI was 25.49 (26). Analyses showed that 1-year composite end point of hospital readmissions and ED visits were significantly higher in non-adherent patients compared to adherent patients. The hazard ratio was determined to be 1.24 with 95%CI 1-1.54(p=0.03). In the multivariate Cox model, adjusting for age and gender, the adjusted HR was 1.27 with 95%CI: 1.02 – 1.58 (p = 0.033). The one-year total cost of healthcare was significantly higher among non-adherent patients (p< 0.001). Conclusion Early detection of OSA in hospitalized patients in Appalachia and successful treatment may significantly lower healthcare utilization. These may have practical impact on quality of life and cost of healthcare delivery in rural hospitals. Support (if any)