Survival and Risk Factors Associated with Mortality in Patients with Sleep Apnoea in Colombia: A Retrospective Cohort Study

Abstract

Background: Survival in patients with sleep apnoea (SA) can be reduced by variables such as age, sex, and comorbidities. However, survival data in patients with SA in Colombia remains scarce. Methods: This is a retrospective cohort study of patients diagnosed with SA between 2005 and 2022. Five-year survival was assessed using the Kaplan-Meier method, and survival curves were stratified by age, sex, and cardiovascular disease. Risk factors associated with survival were evaluated using Hazard Ratio (HR) by adjusting for confounding variables with a Cox regression model. A minimum sample size of 1537 patients were estimated to be necessary to estimate a survival incidence rate with a 5% precision. Results: The five-year survival rate in the general population was 94.6%, with lower survival in patients over 65 years (88.5% vs 97.9%; p < 0.001) and in patients with cardiovascular disease (89% vs 95.2%; p < 0.001) compared to the control group. In the Cox regression, age showed an HR of 1.05 (95% CI: 1.02–1.07; p < 0.001). Male sex had an HR of 2.31 (95% CI: 1.25–4.25; p = 0.007), congestive heart failure an HR of 4.00 (95% CI: 2.31–6.94; p < 0.001), chronic obstructive pulmonary disease (COPD) an HR of 1.75 (95% CI: 1.04–2.96; p = 0.035), chronic kidney disease (CKD) an HR of 2.23 (95% CI: 1.31–3.78; p = 0.003), and metastatic cancer an HR of 4.96 (95% CI: 1.95–12.60; p = 0.001). Conclusion: The study showed a high five-year survival rate in patients with SA. The risk factors associated with decreased overall five-year survival were age, male sex, cardiovascular disease, COPD, CKD, and metastatic cancer.