Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2022, Vol. 36 ›› Issue (4): 73-78.doi: 10.6040/j.issn.1673-3770.0.2021.180

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The utility of different values of average oxygen saturation and minimum oxygen saturation between different sleep stages for predicting the uvulopalatopharyngoplastysurgery effect

HAN Jibo, DONG Jie, MING Wei, WANG Yan, LUO Zhihong   

  1. Department of Otorhinolaryngology & Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, China
  • Published:2022-07-11

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Abstract: Objective The objective of this study was to explore whether the difference in average blood oxygen saturation and lowest oxygen saturation between different sleep stages could predict the effect of uvulopalatopharyngoplasty(UPPP)surgery. Methods Preoperative and postoperative PSG data from 117 patients(113 men and 4 women)with OSA admitted to our hospital between May 2015 and June 2018 were retrospectively analyzed. After computing the average oxygen saturation difference value(ΔAvSaO2)and the lowest oxygen saturation difference value(ΔLSaO2)between the REM and NREM sleep stages in preoperative patients, a linear correlation analysis was conducted with the postoperative AHI drop ratio(ΔAHI%). Using ΔAHI %≥50% as an effective operation, we drew the receiver operating characteristic(ROC)curves for ΔAvSaO2 and ΔLSaO2.We then calculated the cutoff value to determine the optimal threshold for predicting the operation effect, and also conducted further unconditionallogistic regression analyses on the predictors. Results The preoperative ΔAvSaO2、ΔLSaO2 between REM and NREM sleep stages were negatively correlated with ΔAHI% and had Pearson correlation coefficients of r=0.881 and 0.849, respectively(P<0.001), indicating the possibility of that both as the prediction index for the effect of UPPP surgery. The ΔAvSaO2 area under the curve was 0.888, 95% CI: 0.830-0.945(P<0.001), and ΔAvSaO2=3.25 was the best threshold for predicting the UPPP surgery effect. Its sensitivity, specificity, positive predictive value, and negative predictive value were 0.836, 0.804, 0.822, and 0.818, respectively. The ΔLSaO2 area under the curve was 0.931, 95% CI:0.889-0.973(P<0.001), and ΔLSaO2=8.75 was the best threshold for predicting the UPPP surgery effect. Its sensitivity, specificity, positive predictive value, and negative predictive values were 0.836, 0.875, 0.879, and0.831, respectively. Unconditional logistic regression analysis showed that patients with OSA with smaller preoperative oxygen saturation difference values between REM and NREM sleep stages may have more effective outcomes with UPPP surgery. The prediction accuracy was 84.6% for a combination of both predictors for the UPPP surgery effect. Conclusion The difference in oxygen saturation between REM and NREM in patients with OSA can be used as a good index to predict the outcome of UPPP surgery.

Key words: Obstructive sleep apnea, Sleep stages, Average oxygen saturation, Lowest oxygen saturation, Uvulopalatopharyngoplasty

CLC Number: 

  • R766.9
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