Predictors of Decision to Pursue Sleep Surgery

Monday, September 30, 2024

10:06 AM – 10:12 AM EDT

Location: MBCC, 238-239

Disclosure(s):

Tiffany Husman, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Amrita N. Bhat, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Megan L. Durr, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Jolie L. Chang, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Sleep surgery is an important part of obstructive sleep apnea (OSA) treatment; however, it is not clear what factors influence which patients decide to proceed to surgery. We aim to identify predictors of who decides on pursuing sleep apnea surgery following initial consultation with a sleep surgeon.

Methods: We performed a retrospective review of a cohort of OSA patients who presented for evaluation at a sleep surgery clinic from November 2021 to March 2023. Intake form and clinical data of patients who pursued surgical intervention and patients who did not pursue intervention was then analyzed.

Results: In total, 143 patients were identified in this study, of which 114 did not have surgery, and 29 had surgical intervention, including DISE (n = 28), hypoglossal nerve stimulation (n = 10), septoplasty and inferior turbinate reduction (n = 3), pharyngoplasty (n = 2), and lingual tonsillectomy (n = 1). No significant differences existed between the average age, BMI, and ESS and ISI scores of the intervention vs no intervention groups. Patients who elected to have surgery had significantly higher AHI compared to those who did not have surgery (29.4 +/- 15.7 vs. 20.7 +/- 18.6, p = 0.01). A higher proportion of those who had surgery had discontinued positive airway pressure (PAP) treatment at the time of consultation compared to patients who did not have intervention (48% vs. 29%, p = 0.047). Finally, the average decisional conflict scale (DCS) score was significantly lower for patients who underwent surgery vs those who did not (19.6 2 +/- 10.8 vs. 32.5 +/- 11.4, p < 0.01). The surgical treatment group was interested in fewer treatment options than those who did not receive surgery (2.3 +/- 1.7 vs. 3.3 +/- 2.6 options, p = 0.01).

Conclusions: Higher baseline AHI, lower decisional conflict score, and discontinuation of PAP use were predictors of patient decision to proceed with sleep surgery after consultation. Interventions to select and understand the decision-making process for sleep surgery are essential in providing adequate decision support and counseling for OSA therapies.

Presenting Author(s)

Tiffany Husman, BS

Medical Student
Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco
San Francisco, CA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Amrita N. Bhat, BS

Medical Student
Washington University School of Medicine in St. Louis
Los Altos, CA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

Megan L. Durr, MD

Associate Professor
University of California, San Francisco
San Francisco, California, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
JC

Jolie L. Chang, MD

Associate Professor, Otolaryngology HNS
University of California San Francisco
San Francisco, CA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.