Skip to main content
AAO-HNSF 2024 Annual Meeting & OTO EXPO Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Back

Scientific Oral Presentations

Sleep Medicine

Session: Scientific Oral Presentations 1 - Sleep Medicine

Association of Modified Sleep Apnea Severity Index With Cardiovascular Risk in CPAP-Intolerant Sleep Surgery Patients

Saturday, September 28, 2024
4:48 PM – 4:54 PM EDT
Location: MBCC, 238-239
Disclosure(s):
Jennifer A. Goldfarb, MHS:

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

Praneet Chandra Kaki, BS:

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

Nicole Louise Molin, MD:

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

Maurits S. Boon, MD:

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

Colin T. Huntley, MD:

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

Introduction: The modified sleep apnea severity index (mSASI), which combines patient anatomy, weight, sleep study metrics, and symptoms, offers a more nuanced measure of obstructive sleep apnea (OSA) than the apnea-hypopnea index (AHI). Prior studies have shown that the mSASI correlates with mean arterial pressure and serum C-reactive protein in OSA patients. Our study aims to assess the association between the mSASI and cardiovascular (CV) risk factors in patients seen in a sleep surgery clinic.

Methods: We conducted a retrospective cohort study at a single tertiary care academic center. CPAP-intolerant OSA patients underwent upper airway stimulation (UAS), maxillomandibular advancement (MMA), or expansion sphincter pharyngoplasty (ESP) at our institution from 2014-2021. The mSASI is scored from 1–3, where 3 indicates the highest OSA severity. Cardiovascular risk factors including Coronary Artery Disease, Type 2 Diabetes Mellitus, Atrial Fibrillation, Congestive Heart Failure, Hypertension (HTN), and Cerebrovascular Accident were assessed at the time of initial evaluation by the sleep surgery team. Chi-square and Wilcoxon rank sum test analyses were performed using R Studio.

Results: Of the 260 patients included, 142 (55%) had an mSASI = 1, 91 (35%) had an mSASI = 2, and 27 (10%) had an mSASI = 3. At least one CV risk factor was present in 58% of patients with mSASI = 1, 68% of patients with mSASI = 2, and 63% of patients with an mSASI = 3 (p=0.3). Patients with an mSASI of 2 or 3 had, on average, more CV risk factors (0.97) than those with an mSASI of 1 (0.72, p=0.02) upon initial presentation, and were also more likely to be diagnosed with HTN (60% v 45%, p=0.02). When stratified by AHI, patients with moderate-severe OSA (AHI>15) had a similar number of CV risk factors as those with mild OSA (AHI < 15) (p>0.05).

Conclusions: The mSASI may offer additional benefits in assessing OSA risk severity based on CV risk factors compared to the AHI alone. Further research is needed to evaluate the utility of this composite index in holistically characterizing OSA disease burden.

    Presenting Author(s)

  • Jennifer A. Goldfarb, MHS

    Medical Student
    Sidney Kimmel Medical College, Thomas Jefferson University
    Philadelphia, PA, United States

    Disclosure(s):

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

    • Co-Author(s)

  • Praneet C. Kaki, BS

    Medical Student
    Sidney Kimmel Medical College, Thomas Jefferson University
    Kendall Park, New Jersey, United States

    Disclosure(s):

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

  • MX

    Melissa C. Xu, BS

    Student
    Sidney Kimmel Medical College at Thomas Jefferson University
    Philadelphia, PA, United States

    Disclosure information not submitted.

  • Daniel J. Campbell, MD

    Resident Physician
    Thomas Jefferson University Hospital
    Philadelphia, PA, United States

    Disclosure information not submitted.

  • Nicole L. Molin, MD

    Physician
    ENT consultants of Nevada
    Las Vegas, Nevada, United States

    Disclosure(s):

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

  • MB

    Maurits S. Boon, MD

    Professor
    Thomas Jefferson University Hospital - Department of Otolaryngology
    Philadelphia, PA, United States

    Disclosure(s):

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

    • Senior Author(s)

  • Colin T. Huntley, MD

    Associate Professor
    Thomas Jefferson University Hospital - Department of Otolaryngology
    Philadelphia, Pennsylvania, United States

    Disclosure(s):

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