Effects of multilevel OSA surgery on patients with poor cardiopulmonary performance: A prospective pilot study

Chung-Wei Lin, Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Pei-Wen Lin, Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; College of Medicine, Chang Gung University, Taoyuan and Kaohsiung, Taiwan; Sleep Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; School of Medicine and Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan.
Li-Wen Chiu, Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Mao-Chang Su, College of Medicine, Chang Gung University, Taoyuan and Kaohsiung, Taiwan; Sleep Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Han-Tan Chai, College of Medicine, Chang Gung University, Taoyuan and Kaohsiung, Taiwan; Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Chun-Tuan Chang, Department of Business Management, Institute of Healthcare Management, National Sun Yat-sen University, Kaohsiung, Taiwan.
Michael Friedman, Advocate Health - MidwestFollow
Anna M. Salapatas, Advocate Health - Midwest
Hsin-Ching Lin, Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; College of Medicine, Chang Gung University, Taoyuan and Kaohsiung, Taiwan; Sleep Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; School of Medicine and Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan; Department of Business Management, Institute of Healthcare Management, National Sun Yat-sen University, Kaohsiung, Taiwan; Robotic Surgery Center and Center for Quality Management, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan. Electronic address: hclin@adm.cgmh.org.tw.

Affiliations

Advocate Illinois Masonic Medical Center

Abstract

Objective:Multilevel airway surgery for obstructive sleep apnea/hypopnea syndrome (OSA) has benefits in improving sleep quality, but its effect on polysomnography (PSG) and 6-minute walk test (6MWT) parameters, including walking distance and cardiopulmonary performance, in patients with poor pre-operative cardiopulmonary performance remains understudied, which should be further investigated.

Methods:This prospective pilot study enrolled 27 consecutive OSA patients with poor pre-operative 6MWT results. All patients received multilevel OSA surgery, and the alterations of sleep parameters and 6MWT profiles were studied. The pre- and post-operative values of polysomnographic data and 6MWT profiles were analyzed using the Wilcoxon signed-rank tests. The relationships among changes of the indices of PSG and 6MWT were further investigated with the Spearman's correlations.

Results:After surgery, the sleep parameters and certain cardiopulmonary indices improved. When analyzing the correlations among changes of the indices of PSG and 6MWT, the improvement of daytime sleepiness (with ESS) was found related to farther walking distance (ρ=-0.414, p = 0.032) and higher percentage of "distance/target distance" (ρ=-0.435, p = 0.023). Moreover, the change of maximal expiratory pressure was the only index associated with the changes of AHI (apnea/hypopnea index, /hr.; ρ=-0.407, p = 0.035) and AHI in REM (ρ=-0.502, p = 0.009) among the cardiopulmonary performance parameters.

Conclusion:This pilot study showed that OSA patients with poor pre-operative cardiopulmonary status undergoing multilevel sleep surgery could experience improvement in the sleep study and 6MWT to some extent. The relatively better walking distance and cardiopulmonary performance after the operation might potentially result from the improvement of daytime sleepiness and better respiration.

Document Type

Article

PubMed ID

39467476

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