Abstract
OBJECTIVE: To investigate the effect of weight loss on short-term efficacy of patients with obstructive sleep apnea (OSA) after surgery. METHODS: The case data of 200 OSA patients who received surgical intervention and underwent low-calorie diet and exercise to lose weight after operation were retrospectively analyzed. The data of efficacy, polysomnography (PSG), Calgary Sleep Apnea Quality of Life Index (SAQLI), Epworth Somnolence Scale (ESS), and snoring score (SS) before and after operation were analyzed between the loss weight group (LG) and constant weight group (CG). Following the identification of predictors of treatment efficacy by univariate analysis and Logistic regression modeling, a nomogram was developed and validated for performance evaluation. RESULTS: Compared to CG, the overall effectiveness (91.67% v.s. 67.97%, P<0.001), apnea-hypopnea index (AHI; 36.57±17.20 events/hour v.s. 50.85±18.50 events/hour; P<0.001), lowest arterial oxygen saturation (LSaO2; 0.84±0.11 v.s. 0.77±0.09; P<0.001), the percentage of total recording time with arterial oxygen saturation below 90% (TS90%; 18.07±11.26% v.s. 24.00±13.98%; P<0.001), the total score of SAQLI (5.44±0.69 score v.s. 5.03±0.71 score; P<0.001), ESS (8.96±4.68 score v.s. 12.13±4.27 score; P<0.001), and SS (4.97±1.62 score v.s. 5.91±1.54 score; P<0.001) in LG were significantly improved after surgery (P<0.01). According to univariate analysis and multivariable analysis, body mass index (BMI; OR=1.334, 95% CI: 1.134-1.569, P=0.001), neck circumference (NC; OR=1.260, 95% CI: 1.048-1.515, P=0.014), dietary management (OR=0.327, 95% CI: 0.151-0.710, P=0.005), and sustained exercise (OR=0.313, 95% CI: 0.138-0.709, P=0.005) exert independent effects on OSA treatment. Using these variables, a nomogram for forecasting unsuccessful OSA treatment was constructed. When subjected to 1000 Bootstrap resampling tests, the model achieved a C-index of 0.805 (95% CI: 0.721-0.884), demonstrating strong model discrimination. Calibration curves indicated accurate prediction performance in the low and intermediate risk categories. CONCLUSION: Effective control of body weight after surgery can significantly improve the short-term efficacy and quality of life of patients with OSA.