30-Day Postoperative Outcomes in Adults with Obstructive Sleep Apnea Undergoing Upper Airway Surgery

Area of Science:

• Sleep Medicine
• Surgical Outcomes Research
• Public Health

Background:

• Obstructive sleep apnea (OSA) is a prevalent upper airway disorder.
• Previous OSA surgery research often relied on single-institution data.
• A multi-institutional national database analysis was conducted to evaluate OSA surgery outcomes.

Purpose of the Study:

• To investigate the postoperative outcomes of obstructive sleep apnea surgery.
• To identify risk factors associated with complications following OSA surgery.
• To analyze national-level data for a comprehensive understanding of OSA surgical safety.

Main Methods:

• Retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database (2008-2020).
• Inclusion of patients who underwent OSA surgery.
• Assessment of 30-day postoperative outcomes (complications, reoperation, readmission, mortality) and risk factors (comorbidities, blood values).

Main Results:

• The study included 4662 patients; common comorbidities were obesity (63%) and hypertension (31%).
• The overall complication rate was 6.3%, with two (0.04%) 30-day postoperative deaths.
• Risk factors for complications included increased BMI, male sex, diabetes, treated hypertension, inpatient setting, ASA class ≥ 4, and elevated alkaline phosphatase (ALP).

Conclusions:

• National-level analysis of OSA surgery reveals complications are associated with ALP levels, male gender, high BMI, and diabetes mellitus.
• OSA surgery demonstrates a generally favorable safety profile.
• Incorporating identified risk factors into perioperative care can potentially improve patient outcomes.