title: Risk of Cerebrovascular Diseases After Uvulopalatopharyngoplasty in Patients With Obstructive Sleep Apnea: A Nationwide Cohort Study.
abstract: Little was known about the beneficial effects of uvulopalatopharyngoplasty (UPPP) on the outcomes after obstructive sleep apnea (OSA). The aim of this study is to investigate the effects of UPPP on reducing risk of cerebrovascular diseases in patients with OSA.Using Taiwan's National Health Insurance Research Database, we conducted a retrospective cohort study of 10,339 patients with new OSA between January 1, 2004, and December 31, 2009. The incident cerebrovascular disease was identified during the 1-year follow-up period in patients with and without receiving UPPP. The rate ratios (RRs) and 95% confidence intervals (CIs) of cerebrovascular disease associated with receiving UPPP in patients with OSA were calculated in multivariate Poisson regression.The 1-year incidences of cerebrovascular disease for OSA patients with and without UPPP were 1.06% and 5.14%, respectively. Patients with OSA receiving UPPP had lower risk of cerebrovascular disease compared with those without UPPP (RR, 0.45; 95% CI, 0.33-0.61). The decreased risk of cerebrovascular disease following UPPP was observed in both sexes and all age groups. In the stratified analysis of medical conditions, the RR of cerebrovascular disease associated with UPPP for patients with 0, 1, ≥ 2 medical conditions were 0.28 (95% CI 0.12-0.68), 0.39 (95% CI 0.21-0.73), and 0.63 (95% CI 0.43-0.93), respectively.Patients with OSA who received UPPP had lower risk of cerebrovascular disease within 1 year after surgery compared with patients not receiving UPPP. Clinical physicians could have more evidence to persuade patients to receive surgical intervention, especially those who have severe OSA symptoms or do not acquire adequate symptom relief under conservative treatments.
authors.affiliation: From the Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan (S-YC, Y-GC, S-YH); School of Medicine, Taipei Medical University, Taipei, Taiwan (Y-GC, F-PL, C-CL, T-LC); Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan (F-PL); Department of Surgery, China Medical University Hospital, Taichung, Taiwan (C-CY); Department of Surgery, University of Illinois, Chicago (C-CY); Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan (C-JH); Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan (C-CL, T-LC); Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan (C-CL, T-LC); School of Chinese Medicine, China Medical University, Taichung, Taiwan (C-CL).
authors.forename: Shin-Yan
authors.initials: SY
authors.lastname: Chen
authors.forename: Yih-Giun
authors.initials: YG
authors.lastname: Cherng
authors.forename: Fei-Peng
authors.initials: FP
authors.lastname: Lee
authors.forename: Chun-Chieh
authors.initials: CC
authors.lastname: Yeh
authors.forename: Shih-Yu
authors.initials: SY
authors.lastname: Huang
authors.forename: Chaur-Jong
authors.initials: CJ
authors.lastname: Hu
authors.forename: Chien-Chang
authors.initials: CC
authors.lastname: Liao
authors.forename: Ta-Liang
authors.initials: TL
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002561:Cerebrovascular Disorders / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010160:Palate, Soft / Q000601:surgery*; D010614:Pharynx / Q000601:surgery*; D012189:Retrospective Studies; D012306:Risk; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D013624:Taiwan / Q000453:epidemiology; D014609:Uvula / Q000601:surgery*