Bio

Clinical Focus


  • Pulmonary Disease
  • Critical Care

Academic Appointments


Administrative Appointments


  • Co-Director - Pulmonary and Critical Care Grand Rounds, Stanford University (2013 - Present)
  • Associate - Center for Health Policy and Center for Primary Care Outcomes Research, Stanford University (2008 - Present)
  • Co-Director - Pulmonary and Critical Care Journal Club, Stanford University (2008 - Present)

Honors & Awards


  • Mentored Clinical Scientist National Research Award (K08), Agency for Healthcare Research and Quality (AHRQ) (2012 - 2017)
  • Ruth L. Kirschstein National Research Service Award (F32), Agency for Healthcare Research and Quality (AHRQ) (2008 - 2010)
  • Helena Anna Henzl Gabor Young Women in Science Award, Stanford University (2007)
  • Resident Award for Excellence in Teaching, Northwestern University (2001, 2002, 2003)
  • Phi Beta Kappa, University of California, San Diego (1995)
  • Magna Cum Laude, University of California, San Diego (1996)
  • Regents Scholar, University of California, San Diego (1994-1996)
  • Highest Departmental Honors, University of California, San Diego (1996)

Professional Education


  • Fellowship:Stanford University School of Medicine (2008) CA
  • Medical Education:Georgetown University (2001) DC
  • Residency:Feinberg School of Medicine - Northwestern University (2004) IL
  • Board Certification: Critical Care Medicine, American Board of Internal Medicine (2008)
  • Board Certification: Pulmonary Disease, American Board of Internal Medicine (2007)
  • Board Certification: Internal Medicine, American Board of Internal Medicine (2004)
  • Fellowship:Yale School of Medicine (2006) CT
  • Internship:Feinberg School of Medicine - Northwestern University (2002) IL

Research & Scholarship

Current Research and Scholarly Interests


I have a fantastic research team and we love working together :) My lab uses mathematical modeling, decision analysis, prognostic modeling, multivariate logistic regression, cost-effectiveness analysis, and meta-analysis to examine pandemic Influenza. We collaborate with colleagues in the Center for Health Policy / Center for Primary Care and Outcomes Research (CHP-PCOR) and Department of Management Science and Engineering at Stanford, the School of Public Health at the University of Michigan, and the U.S. Centers for Disease Control and Prevention (CDC) to examine and design pandemic influenza mitigation strategies.

Teaching

2014-15 Courses


Graduate and Fellowship Programs


Publications

Journal Articles


  • Centralized Monitoring and Virtual Consultant Models of Tele-ICU Care: A Systematic Review TELEMEDICINE AND E-HEALTH Ramnath, V. R., Ho, L., Maggio, L. A., Khazeni, N. 2014; 20 (10): 936-961
  • Centralized Monitoring and Virtual Consultant Models of Tele-ICU Care: A Side-by-Side Review TELEMEDICINE AND E-HEALTH Ramnath, V. R., Khazeni, N. 2014; 20 (10): 962-971
  • Seasonal Patterns in Human A (H5N1) Virus Infection: Analysis of Global Cases PLOS ONE Mathur, M. B., Patel, R. B., Gould, M., Uyeki, T. M., Bhattacharya, J., Xiao, Y., Gillaspie, Y., Chae, C., Khazeni, N. 2014; 9 (9)
  • Impact of insulin resistance on ventricular function in pulmonary arterial hypertension. journal of heart and lung transplantation Brunner, N. W., Skhiri, M., Fortenko, O., Hsi, A., Haddad, F., Khazeni, N., Zamanian, R. T. 2014; 33 (7): 721-726

    Abstract

    Insulin resistance (IR) is an independent prognostic marker in pulmonary arterial hypertension (PAH), although the mechanism by which it engenders risk is unknown. We prospectively investigated the clinical, laboratory, hemodynamic, and echocardiographic characteristics of insulin-sensitive (IS) and IR patients with PAH.This was a prospective cohort study including well-phenotyped patients with PAH proven at cardiac catheterization. Patients were classified as IS or IR on the basis of the well-validated triglyceride/high-density lipoprotein-cholesterol ratio. Clinical, laboratory, and hemodynamic characteristics were compared between cohorts. Distance walked on the 6-minute walk test (6MWT) and echocardiograms were compared between IS and IR for the sub-set of patients that had these tests within 1 month of cardiac catheterization.Of the 111 PAH patients enrolled, 59 were IS, 25 were IR, and 27 were classified as indeterminate. Mean age was 45.8 15.0 years. IR was associated with worse New York Heart Association class (p = 0.02). There were no differences in hemodynamics, biomarkers, 6MWT distance, or parameters of right ventricular function (i.e., tricuspid annular plane systolic excursion, myocardial performance index, and fractional area change) between groups. Despite similar systemic vascular resistance, parameters of left ventricular diastolic function were more favorable for IS vs IR, including mitral inflow E wave velocity (82 17 vs 64 19 msec, p = 0.02), E/A ratio (1.2 0.4 vs 0.8 0.2, p = 0.01), and lateral mitral valve E' velocity (13.9 3.5 vs 10.4 2.2 msec, p = 0.01).IR is associated with worse functional class and diastology compared with IS in PAH, although other prognostic parameters are similar.

    View details for DOI 10.1016/j.healun.2014.02.016

    View details for PubMedID 24819985

  • Health and Economic Benefits of Early Vaccination and Nonpharmaceutical Interventions for a Human Influenza A (H7N9) Pandemic: A Modeling Study. Annals of internal medicine Khazeni, N., Hutton, D. W., Collins, C. I., Garber, A. M., Owens, D. K. 2014; 160 (10): 684-694

    Abstract

    Vaccination for the 2009 pandemic did not occur until late in the outbreak, which limited its benefits. Influenza A (H7N9) is causing increasing morbidity and mortality in China, and researchers have modified the A (H5N1) virus to transmit via aerosol, which again heightens concerns about pandemic influenza preparedness.To determine how quickly vaccination should be completed to reduce infections, deaths, and health care costs in a pandemic with characteristics similar to influenza A (H7N9) and A (H5N1).Dynamic transmission model to estimate health and economic consequences of a severe influenza pandemic in a large metropolitan city.Literature and expert opinion.Residents of a U.S. metropolitan city with characteristics similar to New York City.Lifetime.Societal.Vaccination of 30% of the population at 4 or 6 months.Infections and deaths averted and cost-effectiveness.In 12 months, 48254 persons would die. Vaccinating at 9 months would avert 2365 of these deaths. Vaccinating at 6 months would save 5775 additional lives and $51 million at a city level. Accelerating delivery to 4 months would save an additional 5633 lives and $50 million.If vaccination were delayed for 9 months, reducing contacts by 8% through nonpharmaceutical interventions would yield a similar reduction in infections and deaths as vaccination at 4 months.The model is not designed to evaluate programs targeting specific populations, such as children or persons with comorbid conditions.Vaccination in an influenza A (H7N9) pandemic would need to be completed much faster than in 2009 to substantially reduce morbidity, mortality, and health care costs. Maximizing non-pharmaceutical interventions can substantially mitigate the pandemic until a matched vaccine becomes available.Agency for Healthcare Research and Quality, National Institutes of Health, and Department of Veterans Affairs.

    View details for DOI 10.7326/M13-2071

    View details for PubMedID 24842415

  • Whole-Exome Sequencing Reveals TopBP1 as a Novel Gene in Idiopathic Pulmonary Arterial Hypertension AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE Perez, V. A., Yuan, K., Lyuksyutova, M. A., Dewey, F., Orcholski, M. E., Shuffle, E. M., Mathur, M., Yancy, L., Rojas, V., Li, C. G., Cao, A., Alastalo, T., Khazeni, N., Cimprich, K. A., Butte, A. J., Ashley, E., Zamanian, R. T. 2014; 189 (10): 1260-1272

    Abstract

    Rationale: Idiopathic pulmonary arterial hypertension (IPAH) is a life-threatening disorder characterized by progressive loss of pulmonary microvessels. While mutations in the bone morphogenetic receptor (BMPR) 2 are found in 80% of heritable and 15% of IPAH patients, their low penetrance (20%) suggests that other as-yet unidentified genetic modifiers are required for manifestation of the disease phenotype. Use of whole exome sequencing (WES) has recently led to the discovery of novel susceptibility genes in heritable PAH but whether WES can also accelerate gene discovery in IPAH remains unknown. Objectives: To determine whether WES can help identify novel gene modifiers in IPAH patients. Methods and Measurements: Exome capture and sequencing was performed on genomic DNA isolated from 12 unrelated IPAH patients lacking BMPR2 mutations. Observed genetic variants were prioritized according to their pathogenic potential using ANNOVAR. Main Results: A total of 10 genes were identified as high priority candidates. Our top hit was TopBP1, a gene involved in the response to DNA damage and replication stress. We found that TopBP1 expression was reduced in vascular lesions and pulmonary endothelial cells isolated from IPAH patients. While TopBP1 deficiency made endothelial cells susceptible to DNA damage and apoptosis in response to hydroxyurea, its restoration resulted in less DNA damage and improved cell survival. Conclusions: WES led to the discovery of TopBP1, a gene whose deficiency may increase susceptibly to small vessel loss in IPAH. We predict that use of WES will help identify gene modifiers that influence an individual's risk of developing IPAH.

    View details for DOI 10.1164/rccm.201310-17490C

    View details for Web of Science ID 000336017200018

  • Demographic and clinical predictors of mortality from highly pathogenic avian influenza A (H5N1) virus infection: CART analysis of international cases. PloS one Patel, R. B., Mathur, M. B., Gould, M., Uyeki, T. M., Bhattacharya, J., Xiao, Y., Khazeni, N. 2014; 9 (3)

    Abstract

    Human infections with highly pathogenic avian influenza (HPAI) A (H5N1) viruses have occurred in 15 countries, with high mortality to date. Determining risk factors for morbidity and mortality from HPAI H5N1 can inform preventive and therapeutic interventions.We included all cases of human HPAI H5N1 reported in World Health Organization Global Alert and Response updates and those identified through a systematic search of multiple databases (PubMed, Scopus, and Google Scholar), including articles in all languages. We abstracted predefined clinical and demographic predictors and mortality and used bivariate logistic regression analyses to examine the relationship of each candidate predictor with mortality. We developed and pruned a decision tree using nonparametric Classification and Regression Tree methods to create risk strata for mortality.We identified 617 human cases of HPAI H5N1 occurring between December 1997 and April 2013. The median age of subjects was 18 years (interquartile range 6-29 years) and 54% were female. HPAI H5N1 case-fatality proportion was 59%. The final decision tree for mortality included age, country, per capita government health expenditure, and delay from symptom onset to hospitalization, with an area under the receiver operator characteristic (ROC) curve of 0.81 (95% CI: 0.76-0.86).A model defined by four clinical and demographic predictors successfully estimated the probability of mortality from HPAI H5N1 illness. These parameters highlight the importance of early diagnosis and treatment and may enable early, targeted pharmaceutical therapy and supportive care for symptomatic patients with HPAI H5N1 virus infection.

    View details for DOI 10.1371/journal.pone.0091630

    View details for PubMedID 24667532

  • Long-term Marijuana Use and Pulmonary Function JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION Patel, R. B., Khazeni, N. 2012; 307 (17): 1796-1796

    View details for Web of Science ID 000303386800010

    View details for PubMedID 22550189

  • Rifaximin for Irritable Bowel Syndrome without Constipation NEW ENGLAND JOURNAL OF MEDICINE Khazeni, N., Perlroth, D. 2011; 364 (15): 1467-1468

    View details for Web of Science ID 000289467200016

    View details for PubMedID 21488770

  • Diagnostic Strategy for Hematology and Oncology Patients with Acute Respiratory Failure AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE Gohil, A., Khazeni, N. 2011; 183 (2): 279-279

    View details for Web of Science ID 000286644000023

    View details for PubMedID 21242597

  • Effectiveness and Cost-Effectiveness of Expanded Antiviral Prophylaxis and Adjuvanted Vaccination Strategies for an Influenza A (H5N1) Pandemic ANNALS OF INTERNAL MEDICINE Khazeni, N., Hutton, D. W., Garber, A. M., Owens, D. K. 2009; 151 (12): 840-U3

    Abstract

    The pandemic potential of influenza A (H5N1) virus is a prominent public health concern of the 21st century.To estimate the effectiveness and cost-effectiveness of alternative pandemic (H5N1) mitigation and response strategies.Compartmental epidemic model in conjunction with a Markov model of disease progression.Literature and expert opinion.Residents of a U.S. metropolitan city with a population of 8.3 million.Lifetime.Societal.3 scenarios: 1) vaccination and antiviral pharmacotherapy in quantities similar to those currently available in the U.S. stockpile (stockpiled strategy), 2) stockpiled strategy but with expanded distribution of antiviral agents (expanded prophylaxis strategy), and 3) stockpiled strategy but with adjuvanted vaccine (expanded vaccination strategy). All scenarios assumed standard nonpharmaceutical interventions.Infections and deaths averted, costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness.Expanded vaccination was the most effective and cost-effective of the 3 strategies, averting 68% of infections and deaths and gaining 404 030 QALYs at $10 844 per QALY gained relative to the stockpiled strategy.Expanded vaccination remained incrementally cost-effective over a wide range of assumptions.The model assumed homogenous mixing of cases and contacts; heterogeneous mixing would result in faster initial spread, followed by slower spread. We did not model interventions for children or older adults; the model is not designed to target interventions to specific groups.Expanded adjuvanted vaccination is an effective and cost-effective mitigation strategy for an influenza A (H5N1) pandemic. Expanded antiviral prophylaxis can help delay the pandemic while additional strategies are implemented.National Institutes of Health and Agency for Healthcare Research and Quality.

    View details for Web of Science ID 000272728900002

    View details for PubMedID 20008760

  • Effectiveness and Cost-Effectiveness of Vaccination Against Pandemic Influenza (H1N1) 2009 ANNALS OF INTERNAL MEDICINE Khazeni, N., Hutton, D. W., Garber, A. M., Hupert, N., Owens, D. K. 2009; 151 (12): 829-U2

    Abstract

    Decisions on the timing and extent of vaccination against pandemic (H1N1) 2009 virus are complex.To estimate the effectiveness and cost-effectiveness of pandemic influenza (H1N1) vaccination under different scenarios in October or November 2009.Compartmental epidemic model in conjunction with a Markov model of disease progression.Literature and expert opinion.Residents of a major U.S. metropolitan city with a population of 8.3 million.Lifetime.Societal.Vaccination in mid-October or mid-November 2009.Infections and deaths averted, costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness.Assuming each primary infection causes 1.5 secondary infections, vaccinating 40% of the population in October or November would be cost-saving. Vaccination in October would avert 2051 deaths, gain 69 679 QALYs, and save $469 million compared with no vaccination; vaccination in November would avert 1468 deaths, gain 49 422 QALYs, and save $302 million.Vaccination is even more cost-saving if longer incubation periods, lower rates of infectiousness, or increased implementation of nonpharmaceutical interventions delay time to the peak of the pandemic. Vaccination saves fewer lives and is less cost-effective if the epidemic peaks earlier than mid-October.The model assumed homogenous mixing of case-patients and contacts; heterogeneous mixing would result in faster initial spread, followed by slower spread. Additional costs and savings not included in the model would make vaccination more cost-saving.Earlier vaccination against pandemic (H1N1) 2009 prevents more deaths and is more cost-saving. Complete population coverage is not necessary to reduce the viral reproductive rate sufficiently to help shorten the pandemic.Agency for Healthcare Research and Quality and National Institute on Drug Abuse.

    View details for Web of Science ID 000272728900001

    View details for PubMedID 20008759

  • Systematic Review: Safety and Efficacy of Extended-Duration Antiviral Chemoprophylaxis Against Pandemic and Seasonal Influenza ANNALS OF INTERNAL MEDICINE Khazeni, N., Bravata, D. M., Holty, J. C., Uyeki, T. M., Stave, C. D., Gould, M. K. 2009; 151 (7): 464-W159

    Abstract

    Neuraminidase inhibitors (NAIs) are stockpiled internationally for extended use in an influenza pandemic.To evaluate the safety and efficacy of extended-duration (>4 weeks) NAI chemoprophylaxis against influenza.Studies published in any language through 11 June 2009 identified by searching 10 electronic databases and 3 trial registries.Randomized, placebo-controlled, double-blind human trials of extended-duration NAI chemoprophylaxis that reported outcomes of laboratory-confirmed influenza or adverse events.2 reviewers independently assessed study quality and abstracted information from eligible studies.Of 1876 potentially relevant citations, 7 trials involving 7021 unique participants met inclusion criteria. Data were pooled by using random-effects models. Chemoprophylaxis with NAIs decreased the frequency of symptomatic influenza (relative risk [RR], 0.26 [95% CI, 0.18 to 0.37]; risk difference [RD], -3.9 percentage points [CI, -5.8 to -1.9 percentage points]) but not asymptomatic influenza (RR, 1.03 [CI, 0.81 to 1.30]; RD, -0.4 percentage point [CI, -1.6 to 0.9 percentage point]). Adverse effects were not increased overall among NAI recipients (RR, 1.01 [CI, 0.94 to 1.08]; RD, 0.1 percentage point [CI, -0.2 to 0.4 percentage point]), but nausea and vomiting were more common among those who took oseltamivir (RR, 1.48 [CI, 1.86 to 2.33]; RD, 1.7 percentage points [CI, 0.6 to 2.9 percentage points]). Prevention of influenza did not statistically significantly differ between zanamivir and oseltamivir.All trials were industry-sponsored. No study was powered to detect rare adverse events, and none included diverse racial groups, children, immunocompromised patients, or individuals who received live attenuated influenza virus vaccine.Extended-duration zanamivir and oseltamivir chemoprophylaxis seems to be highly efficacious for preventing symptomatic influenza among immunocompetent white and Japanese adults. Extended-duration oseltamivir is associated with increased nausea and vomiting. Safety and efficacy in several subpopulations that might receive extended-duration influenza chemoprophylaxis are unknown.

    View details for Web of Science ID 000270470500004

    View details for PubMedID 19652173

  • Does Itraconazole Improve Quality of Life in Severe Asthma with Fungal Sensitization? AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE Khazeni, N., Levitt, J. E. 2009; 180 (2): 191-192

    View details for Web of Science ID 000268112500021

    View details for PubMedID 19578143

  • Quality Improvement Strategies for Children With Asthma A Systematic Review ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE Bravata, D. M., Gienger, A. L., Holty, J. C., Sundaram, V., Khazeni, N., Wise, P. H., McDonald, K. M., Owens, D. K. 2009; 163 (6): E1-E5
  • Quality Improvement Strategies for Children With Asthma A Systematic Review ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE Bravata, D. M., Gienger, A. L., Holty, J. C., Sundaram, V., Khazeni, N., Wise, P. H., McDonald, K. M., Owens, D. K. 2009; 163 (6): 572-581

    Abstract

    To evaluate the evidence that quality improvement (QI) strategies can improve the processes and outcomes of outpatient pediatric asthma care.Cochrane Effective Practice and Organisation of Care Group database (January 1966 to April 2006), MEDLINE (January 1966 to April 2006), Cochrane Consumers and Communication Group database (January 1966 to May 2006), and bibliographies of retrieved articles.Randomized controlled trials, controlled before-after trials, or interrupted time series trials of English-language QI evaluations.Must have included 1 or more QI strategies for the outpatient management of children with asthma.Clinical status (eg, spirometric measures); functional status (eg, days lost from school); and health services use (eg, hospital admissions).Seventy-nine studies met inclusion criteria: 69 included at least some component of patient education, self-monitoring, or self-management; 13 included some component of organizational change; and 7 included provider education. Self-management interventions increased symptom-free days by approximately 10 days/y (P = .02) and reduced school absenteeism by about 0.1 day/mo (P = .03). Interventions of provider education and those that incorporated organizational changes were likely to report improvements in medication use. Quality improvement interventions that provided multiple educational sessions, had longer durations, and used combinations of instructional modalities were more likely to result in improvements for patients than interventions lacking these characteristics.A variety of QI interventions improve the outcomes and processes of care for children with asthma. Use of similar outcome measures and thorough descriptions of interventions would advance the study of QI for pediatric asthma care.

    View details for Web of Science ID 000266566700011

    View details for PubMedID 19487615

  • Does statin use attenuate lung function decline? AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE Khazeni, N., Kuschner, W. G., Gould, M. K. 2008; 177 (6): 671-671

    View details for Web of Science ID 000253852000021

    View details for PubMedID 18316773

  • The Risks of Scanning San Francisco Chronicle Sunday Magazine Khazeni N 2008; Feb. 17
  • Vaccine News You Need San Francisco Chronicle Sunday Magazine Khazeni N 2008; Feb. 3
  • Before You Pop That Viagra, Read This San Francisco Chronicle Sunday Magazine Khazeni N 2008; April 20
  • Cultivating the Follicle San Francisco Chronicle Sunday Magazine Khazeni N 2008; Jan. 13
  • HPV Vaccine Has Multiple Benefits Stanford Medicine News Khazeni N 2008: 7
  • Popping the Placebo Effect San Francisco Chronicle Sunday Magazine Khazeni N 2008; March 23
  • The Mammography Maze San Francisco Chronicle Sunday Magazine Khazeni N 2008; May 25
  • Dangerous Combinations San Francisco Chronicle Sunday Magazine Khazeni N 2008; March 2
  • Vaccine for an Insidious Virus San Francisco Chronicle Sunday Magazine Khazeni N 2008; June 22
  • Chasing the Elusive Cold San Francisco Chronicle Sunday Magazine Khazeni N 2007; July 29
  • Jetting Without the Lag San Francisco Chronicle Sunday Magazine Khazeni N 2007; July 7
  • Keeping Lungs Young San Francisco Chronicle Sunday Magazine Khazeni N 2007; Sept. 23
  • Smells Fishy--But That's Good! San Francisco Chronicle Sunday Magazine Khazeni N 2007; Aug. 19
  • Seeing Into the Future San Francisco Chronicle Sunday Magazine Khazeni N 2007; Nov. 4
  • A Lousy Infection San Francisco Chronicle Sunday Magazine Khazeni N 2007; Oct. 7
  • When Traveling, Get Out of Your Seat! San Francisco Chronicle Sunday Magazine Khazeni N 2007; Aug. 12
  • Shooting Back the Flu San Francisco Chronicle Sunday Magazine Khazeni N 2007; Oct. 14
  • A Crisis of Great Magnitude San Francisco Chronicle Sunday Magazine Khazeni N 2007; Aug. 26
  • A Nap a Day San Francisco Chronicle Sunday Magazine Khazeni N 2007; June 17
  • In the End, the Choice is Yours San Francisco Chronicle Sunday Magazine Khazeni N 2007; Dec. 9
  • Outrunning the Blues San Francisco Chronicle Sunday Magazine Khazeni N 2007; June 24
  • Massive cavitary pulmonary rheumatoid nodules in a patient with HIV EUROPEAN RESPIRATORY JOURNAL Khazeni, N., Homer, R. J., Rubinowitz, A. N., Chupp, G. L. 2006; 28 (4): 872-874

    Abstract

    The case of a 52-yr-old female with rheumatoid arthritis and HIV who developed massive, progressive, cavitary pulmonary nodules is described. Multiple diagnostic bronchoscopies and lung biopsies failed to demonstrate the presence of any microorganisms. Pathological analysis showed palisading histiocytes with necrobiosis consistent with rheumatoid nodules. The effect of co-existing HIV infection on the course and prognosis of rheumatoid arthritis is discussed, and it is concluded that the complex relationship between these two disease processes warrants further investigation.

    View details for DOI 10.1183/09031936.06.00144105

    View details for Web of Science ID 000241345000029

    View details for PubMedID 17012633

  • Morbidity, mortality and sleep-disordered breathing in community dwelling elderly SLEEP ANCOLIISRAEL, S., Kripke, D. F., Klauber, M. R., Fell, R., Stepnowsky, C., ESTLINE, E., Khazeni, N., Chinn, A. 1996; 19 (4): 277-282

    Abstract

    A population-based probability sample of elderly individuals (n = 426), who were originally studied between 1981 and 1986 (mean age at initial study was 72.5 years), were followed for mortality. Those with > or = 30 respiratory disturbances per hour of sleep had significantly shorter survival (p = 0.0034), but the respiratory disturbance index (RDI) was not an independent predictor of death. When Cox proportional hazards analysis was done, only age (the strongest predictor), cardiovascular disease and pulmonary disease were independent predictors of death. It may be that factors that are secondary to or associated with sleep-disordered breathing (SDB), such as cardiovascular or pulmonary disease, predispose these elderly to death.

    View details for Web of Science ID A1996UP60500002

    View details for PubMedID 8776783

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