Open AccessPredictive models of objective oropharyngeal OSA surgery outcomes: Success rate and AHI reduction ratio
Author(s) -
Ji Ho Choi,
Jae Yong Lee,
Jaehyung Cha,
Kangwoo Kim,
Seung No Hong,
Jun Young Lee
Publication year - 2017
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0185201
Subject(s) - medicine , stepwise regression , obstructive sleep apnea , logistic regression , tonsil , polysomnography , confidence interval , surgery , retrospective cohort study , apnea
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—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 x1 − P x) = 1 . 518 − 0 . 039 × Age + 1 . 392 × TS Gr − 0 . 803 × PTP GrThe best predictive equation according to stepwise multiple linear regression analysis was:AHI reduction ratio = − 39 . 464 + ( 32 . 752 × TS Gr ) + ( 2 . 623 × AHI ) − ( 2 . 542 × Arousal index )+ [ 1 . 245 × Minimum Sa O 2 ( % ) ] − [ 0 . 599 × 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.