Sleep Breath. 2026 Jun 9;30(3):181. doi: 10.1007/s11325-026-03657-4.
ABSTRACT
BACKGROUND: Obstructive sleep apnea (OSA) is a prevalent condition that is strongly associated with significant cardiovascular comorbidities and a predictor of poor outcomes, particularly in the postsurgical population. There are limited data for venous thromboembolism (VTE) in post-total hip arthroplasty (THA) patients and examining this association in an observational model can be challenging without a significant number of patients.
METHODS: As part of this retrospective multicentric cohort study, we queried the TriNetX U.S. Collaborative Network, a deidentified, aggregated electronic health record (EHR) platform consisting of over 110 million patients inside the United States. We assessed patients who underwent Current Procedural Terminology (CPT)-coded THA surgery between October 1st 2015 and February 1st 2025 for those patients with ≥ 2 occurrences of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) encounter diagnosis codes for OSA (G47.33) in their records and ≥ 1 occurrence preceding THA. We examined the 28-day incidence of VTE and secondarily its constituents, deep vein thrombosis (DVT), pulmonary embolism (PE), as well as cerebrovascular accident (CVA) and myocardial infarction (MI), in addition to multiple demographic and comorbidity data with which an in-platform propensity score-matched (PSM) analysis was conducted to identify matching controls (without OSA diagnoses).
RESULTS: Out of 180,734 patients who underwent THA in the time period assessed, 33,940 had an OSA diagnosis, while 146,794 had no OSA diagnosis at any time point. Prior to PSM, the OSA cohort carried a significantly higher risk of all outcomes assessed (VTE, DVT, PE, CVA, and MI) in the 28 days following THA surgery. Following PSM, OSA remained significantly associated with VTE (relative risk 1.31, 95% CI 1.15-1.50) as well as the secondary outcomes of DVT, PE, and CVA.
CONCLUSIONS: These findings further support the association of OSA with post-hip arthroplasty VTE, with increased rates of the latter persisting even after extensive propensity matching for associated comorbidities. Further investigation to discern the underlying pathophysiology of this correlation is necessary.
PMID:42262663 | DOI:10.1007/s11325-026-03657-4