Predictive models of objective oropharyngeal OSA surgery outcomes: Success rate and AHI reduction ratio

Abstract

Objective The aim of this study was to develop a predictive model of objective oropharyngeal obstructive sleep apnea (OSA) surgery outcomes including success rate and apnea-hypopnea index (AHI) reduction ratio in adult OSA patients. Study design Retrospective outcome research. Methods All subjects with OSA who underwent oropharyngeal and/or nasal surgery and were followed for at least 3 months were enrolled in this study. Demographic, anatomical [tonsil size (TS) and palate-tongue position (PTP) grade (Gr)], and polysomnographic parameters were analyzed. The AHI reduction ratio (%) was defined as [(postoperative AHI D preoperative AHI) x 100 /postoperative AHI], and surgical success was defined as a >= 50% reduction in preoperative AHI with a postoperative AHI < 20. Results A total of 156 consecutive OSAS adult patients (mean age +/- SD = 38.9 +/- 9.6, M/F = 149 / 7) were included in this study. The best predictive equation by Forward Selection likelihood ratio (LR) logistic regression analysis was: ln(P-x/1 - P-x) = 1.518 x Age + 1.392 x TSGr - 0.803 x PTPGr The best predictive equation according to stepwise multiple linear regression analysis AHIreductionratio = -39.464 + (32.752 x TSGr) + (2.623 x AHI) + (2.542 x Arousalindex) + [1.245] Minimum SaO(2)(%)] - [0.599 x Snoring (%)] (TS/PTP Gr = 1 if TS/PTP Gr 3 or 4, TS/PTP Gr = 0 if TS/PTP Gr 1 or 2) Conclusion The predictive models for oropharyngeal surgery described in this study may be useful for planning surgical treatments and improving objective outcomes in adult OSA patients.