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Examining Demographic Trends of Surgical Intervention for the Treatment of Sleep Apnea: A Study Using the National Inpatient Sample Database (NIS)
Lesley Elizabeth Summerville BS ScM
Samuel Boas BS
Yida Cai BA
Jeremy Ruthberg BA
Anand Kumar MD
Case Western Reserve University School of Medicine
2020-01-30
Presenter: Lesley Elizabeth Summerville
Affidavit:
Lesley Elizabeth Summerville
Director Name: Anand Kumar MD
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Background:
Sleep apnea is a source of serious morbidity, for which surgical intervention is an effective management option, though demographic factors may impact utilization of surgery. In this study, we evaluated demographic disparities in the surgical treatment of sleep apnea.
Methods:
Patients aged over 17 diagnosed with sleep apnea were selected from the 2014 Healthcare Cost and Utilization Project National Inpatient Sample (NIS) database. These were compared against a subset who received relevant surgeries, such as orthognathic surgery and tonsillectomy. Age, race, gender, region, and insurance type were analyzed using SPSS.
Results:
There were 47,585 patients with a diagnosis of sleep apnea, 1,600 of whom received surgery. The surgical cohort was younger (mean of 44.8 vs. 55.9 years; p<0.001), male (72.8% vs. 57.8%; p<0.001), and Hispanic (15.3% vs. 7.5%; p<0.001) compared with the total group. Those receiving surgery were less likely to use Medicare (12.2% vs. 36.3%) and more likely to use private insurance (67.5% vs. 46.7%). The largest percentage of patients were in the Midwest (33.0%), but surgical management was the least prevalent in this region (19.7%).
Conclusions:
This study identified multiple demographic discrepancies in the utilization of surgical management of sleep apnea. Patients utilizing surgery were more likely younger, male, and Hispanic, and privately insured compared with all patients with sleep apnea. Although the largest proportion of patients were Midwestern, surgery was used the least in this region. This data allows for establishment of a predictive patient profile identifying patients more likely to treat sleep apnea with surgery.
