Table 1.
Characteristics of children with SCD stratified by obstructive sleep apnea
| Total (n = 203,705) | No OSA (n = 200,885) | OSA (n = 2,820) | P-value | |
|---|---|---|---|---|
| Demographic characteristics | ||||
| Age, mean (SD) | 9.34 (0.05) | 9.33 (0.05) | 9.92 (0.17) | 0.0001 |
| Age categories | ||||
| 0–4 years, n (%) | 56,787 (27.88) | 56,359 (28.06) | 428 (15.19) | <0.0001 |
| 5–9 years, n (%) | 43,075 (21.15) | 42,147 (20.98) | 928 (32.91) | |
| 10–14 years, n (%) | 49,693 (24.39) | 48,871 (24.33) | 822 (29.17) | |
| 15–18 years, n (%) | 54,149 (26.58) | 53,508 (26.64) | 641 (22.74) | |
| Gender | ||||
| Female, n (%) | 99,400 (48.80) | 98,055 (48.81) | 1,345 (47.70) | 0.3179 |
| Obesity, n (%) | 1,103 (0.54) | 925 (0.46) | 178 (6.31) | <0.0001 |
| Race | ||||
| White, n (%) | 3,368 (1.65) | 3,313 (1.65) | 55 (1.95) | 0.4912 |
| Black, n (%) | 156,650 (76.90) | 154,415 (76.87) | 2,235 (79.27) | |
| Hispanic, n (%) | 8,886 (4.36) | 8,779 (4.37) | 107 (3.80) | |
| Asian or Pacific Islander, n (%) | 393 (0.19) | N/A | N/A | |
| Native American, n (%) | 149 (0.07) | N/A | N/A | |
| Others, n (%) | 3,519 (1.73) | 3,476 (1.73) | 43 (1.51) | |
| Admission season | ||||
| Spring (Mar–May), n (%) | 44,133 (21.67) | 43,441 (21.62) | 692 (24.56) | 0.0058 |
| Summer (Jun–Aug), n (%) | 39,377 (19.33) | 38,775 (19.30) | 602 (21.34) | |
| Fall (Sep–Nov), n (%) | 43,327 (21.27) | 42,690 (21.25) | 637 (22.58) | |
| Winter (Dec–Feb), n (%) | 45,915 (22.54) | 45,305 (22.55) | 610 (22.55) | |
| Insurance | ||||
| Public, n (%) | 118,348 (58.10) | 116,512 (58.00) | 1,836 (65.12) | 0.0001 |
| Private, n (%) | 49,117 (24.11) | 48,501 (24.14) | 616 (21.84) | |
| Others, n (%) | 36,008 (17.68) | 35,649 (17.75) | 359 (12.73) | |
| Median household income | ||||
| 0–25%, n (%) | 87,794 (43.10) | 86,586 (43.10) | 1,208 (42.83) | 0.6028 |
| 26–50%, n (%) | 49,930 (24.51) | 49,277 (24.53) | 653 (23.15) | |
| 51–75%, n (%) | 34,876 (17.12) | 34,379 (17.11) | 497 (17.63) | |
| 76–100%, n (%) | 25,752 (12.64) | 25,356 (12.62) | 395 (14.01) | |
| Hospital region | ||||
| Northeast, n (%) | 50,037 (24.56) | 49,336 (24.56) | 702 (24.89) | 0.014 |
| Midwest, n (%) | 34,828 (17.10) | 34,420 (17.13) | 408 (14.47) | |
| South, n (%) | 98,632 (48.42) | 97,333 (48.45) | 1,299 (46.06) | |
| West, n (%) | 20,208 (9.92) | 19,796 (9.85) | 411 (14.59) | |
| Hospital size | ||||
| Small, n (%) | 29,447 (14.46) | 29,081 (14.48) | 366 (12.96) | 0.0846 |
| Medium, n (%) | 41,981 (20.61) | 41,432 (20.62) | 549 (19.48) | |
| Large, n (%) | 125,497 (61.61) | 123,754 (61.60) | 1,743 (61.83) | |
| Teaching hospital, n (%) | 161,407 (79.24) | 158,985 (79.14) | 2,422 (85.89) | <0.0001 |
| Comorbidity | ||||
| Sickle cell anemia type | ||||
| SS, n (%) | 185,206 (90.92) | 182,654 (90.92) | 2,553 (90.54) | 0.9273 |
| S Beta, n (%) | 6,066 (2.98) | 5,987 (2.98) | 79 (2.81) | |
| SC, n (%) | 7,038 (3.45) | 6,929 (3.45) | 109 (3.88) | |
| Asthma, n (%) | 28,620 (14.05) | 27,340 (13.76) | 980 (34.76) | <0.0001 |
| Hypertension, n (%) | 755 (0.37) | 731 (0.36) | 24 (0.84) | 0.0030 |
| Diabetes mellitus, n (%) | 481 (0.24) | 460 (0.23) | 21 (0.74) | 0.0216 |
| Coagulopathy, n (%) | 788 (0.39) | 770 (0.38) | 18 (0.63) | 0.4098 |
| IDA, n (%) | 558 (0.27) | N/A | N/A | 0.1348 |
| Congenital heart diseases, n (%) | 1,058 (0.52) | 1,029 (0.51) | 29 (1.05) | 0.0022 |
| Treatment | ||||
| Transfusion, n (%) | 38,562 (18.93) | 37,703 (18.77) | 859 (30.48) | <0.0001 |
| Cranial angiography, n (%) | 632 (0.31) | 610 (0.30) | 21 (0.75) | 0.0065 |
| NIMV, n (%) | 977 (0.48) | 870 (0.43) | 106 (3.77) | <0.0001 |
| AT, n (%) | 1,434 (0.70) | 523 (0.26) | 911 (32.31) | <0.0001 |
| T&A, n (%) | 1,190 (0.58) | 373 (0.19) | 816 (28.95) | <0.0001 |
| Tonsillectomy, n (%) | 75 (0.04) | 46 (0.02) | 29 (1.03) | <0.0001 |
| Adenoidectomy, n (%) | 169 (0.08) | 103 (0.05) | 66 (2.34) | <0.0001 |
| Outcomes | ||||
| Neurologic complications, n (%) | 4,447 (2.18) | 4,350 (2.17) | 97 (3.45) | 0.0014 |
| Ischemic stroke, n (%) | 702 (0.34) | 688 (0.34) | 14 (0.51) | 0.4729 |
| Hemorrhagic stroke, n (%) | 137 (0.07) | N/A | N/A | |
| TIA, n (%) | 291 (0.14) | N/A | N/A | 0.8903 |
| Seizures, n (%) | 3,415 (1.68) | 3,333 (1.66) | 82 (2.91) | 0.0003 |
| ACS, n (%) | 12,108 (8.90) | 11,842 (8.85) | 266 (11.27) | 0.0028 |
| VOC, n (%) | 126,562 (62.13) | 125,268 (62.36) | 1,295 (45.92) | <0.0001 |
| Cost of hospitalization*, mean (SD) | 17,184 (465) | 17,084 (459) | 24,223 (1,409) | <0.0001 |
| Length of hospitalization (d), mean (SD) | 4.01 (0.04) | 4.01 (0.04) | 3.94 (0.15) | 0.611 |
| Mortality, n (%) | 246 (0.12) | N/A | N/A | 0.0132 |
OSA, obstructive sleep apnea; TIA, transient ischemic attack; IDA, iron deficiency; NIMV, noninvasive mechanical ventilation; ACS, acute chest syndrome; VOC, vaso-occlusion crisis; SD, standard deviation; n, sample size; d, day; N/A, not available as weighted frequency less than 10.
*Cost was adjusted to 2012 USD using an average consumer price index.