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

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_x / 1 - P_x ) = 1:518 - 0:039 x Age + 1:392 x TSGr - 0.803 x PTPGr The best predictive equation according to stepwise multiple linear regression analysis was: AHIreductionratio = -39.464 + (32.752 x TSGr) + (2.623 x AHI) - (2.542 x Arousalindex) +[1.245 x MinimumSaO₂(%)] - [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.