Impact of obstructive sleep apnea on clinical outcomes of hospitalization due to influenza in children: A propensity score-matched analysis of the US Nationwide Inpatient Sample 2005-2018.

ABSTRACT

BACKGROUND: Previous studies have explored the association between obstructive sleep apnea (OSA) and clinical outcomes of influenza in adults, whereas limited research examined this relationship in pediatric populations. This study aimed to evaluate the clinical impact of OSA on the outcomes of pediatric influenza hospitalizations. METHODS: This was a population-based, retrospective study. Data of children aged 1-19 years hospitalized for influenza infection were extracted from the United States (US) Nationwide Inpatient Sample Database 2005-2018. Univariable and multivariable regression analyses determined associations between OSA, length of stay (LOS), total hospital costs, pneumonia, and life-threatening events. RESULTS: After propensity-score matching, a total of 2100 children were analyzed. The logistic analysis revealed that children with OSA had a significantly increased LOS (ß = 2.29 days; 95% confidence interval, CI 1.01-3.57, p < .001) and total hospital costs (ß = 26.06 thousand dollars; 95% CI 6.62-45.51, p = .009), and higher odds of pneumonia (aged 6-10 years odds ratio [OR] = 1.52; 95% CI 1.01-2.27, p = .043; aged ≥ 11 years OR = 1.83; 95% CI 1.33-2.53, p < .001). CONCLUSIONS: During influenza admissions, children with OSA had longer LOS, higher hospital costs, and an increased risk of pneumonia compared to those without OSA. These findings underscore the importance of recognizing and managing OSA in influenza-related infections among children.