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接受鼻腔手术的阻塞性睡眠呼吸暂停成年患者的人口统计学特征。

Demographics of Adults With Obstructive Sleep Apnea Who Undergo Nasal Surgery.

作者信息

Shah Swapnil, Darbinian Jeanne A, Collazo Samuel A, Nguyen Dang Khoa, Durr Megan L

机构信息

Department of Surgery Creighton University School of Medicine Omaha Nebraska USA.

Department of Head and Neck Surgery Kaiser Permanente, Northern California Oakland California USA.

出版信息

OTO Open. 2024 Sep 17;8(3):e70005. doi: 10.1002/oto2.70005. eCollection 2024 Jul-Sep.

Abstract

OBJECTIVE

To assess the demographic characteristics between adult obstructive sleep apnea (OSA) patients who did and did not undergo nasal surgery (NS).

STUDY DESIGN

Retrospective cohort study.

SETTING

Kaiser Permanente Northern California clinical database.

METHODS

Retrospective study of adult patients with ≥1 OSA diagnoses linked to clinical encounters from 2009 to 2016. Qualifying NS procedures performed on or after cohort entry through 2017 were ascertained. Demographic and clinical characteristics were compared; multivariable logistic regression examined associations of these characteristics with undergoing NS.

RESULTS

A total of 174,821 patients had an OSA diagnosis. Among these, 3518 (2.0%) underwent NS, including septoplasty (61.9%), sinus-related (12.9%), turbinate (14.2%), and rhinoplasty (11.1%) procedures. Compared to the nonsurgery group, NS patients were more likely to be male (75.5% vs 62.1%), younger (48.2 ± 13.0 vs 54.7 ± 14.1), have lower body mass index (31.8 ± 6.4 vs 34.3 ± 8.1), and no comorbid conditions (63.1% vs 53.5%),  < .001. After adjusting for sex, age, body mass index (BMI), neighborhood deprivation, and comorbidities, black and Asian/Pacific Islander adults with OSA had 42% and 46% decreased odds of undergoing NS compared with non-Hispanic white patients (odds ratio, OR [95% confidence interval, CI]: 0.58 [0.50-0.67] and 0.54 [0.49-0.61]), while Hispanic patients had similar odds (OR [95% CI]: 1.02 [0.93-1.12]). Patients living in neighborhoods of highest deprivation had 18% lower odds of undergoing NS, compared with patients from neighborhoods corresponding to areas of lowest deprivation (adjusted odds ratio [95% CI]: 0.82 [0.75-0.91]).

CONCLUSION

These findings suggest that younger age, male sex, lower BMI, and higher SES may be associated with a higher likelihood of undergoing NS in OSA patients.

摘要

目的

评估接受和未接受鼻部手术(NS)的成人阻塞性睡眠呼吸暂停(OSA)患者的人口统计学特征。

研究设计

回顾性队列研究。

研究地点

北加利福尼亚凯撒医疗集团临床数据库。

方法

对2009年至2016年期间有≥1次OSA诊断且与临床诊疗相关的成年患者进行回顾性研究。确定在队列入组后至2017年期间进行的符合条件的NS手术。比较人口统计学和临床特征;多变量逻辑回归分析这些特征与接受NS手术之间的关联。

结果

共有174,821例患者被诊断为OSA。其中,3518例(2.0%)接受了NS手术,包括鼻中隔成形术(61.9%)、鼻窦相关手术(12.9%)、鼻甲手术(14.2%)和隆鼻手术(11.1%)。与未手术组相比,接受NS手术的患者更可能为男性(75.5%对62.1%)、年龄更小(48.2±13.0岁对54.7±14.1岁)、体重指数更低(31.8±6.4对34.3±8.1)且无合并症(63.1%对53.5%),P<0.001。在调整性别、年龄、体重指数(BMI)、社区贫困程度和合并症后,患有OSA的黑人和亚裔/太平洋岛民成年人接受NS手术的几率分别比非西班牙裔白人患者降低了42%和46%(优势比,OR[95%置信区间,CI]:0.58[0.50 - 0.67]和0.54[0.49 - 0.61]),而西班牙裔患者的几率相似(OR[95%CI]:1.02[0.93 - 1.12])。与来自贫困程度最低地区相应社区的患者相比,生活在贫困程度最高社区的患者接受NS手术的几率低18%(调整后的优势比[95%CI]:0.82[0.75 - 0.91])。

结论

这些发现表明,年龄较小、男性、BMI较低和社会经济地位较高可能与OSA患者接受NS手术的可能性较高有关。

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