Impact of OSA Surgery on Cardiovascular, Neurological and Metabolic Health in Geriatric Patients

Sunday, October 12, 2025

2:30 PM - 2:36 PM EDT

Location: 136

Disclosure(s):

Elaine Costa, MD, MSc:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Pedro M. Gomes de Oliveira, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Robson Capasso, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Surgical treatment for obstructive sleep apnea (OSA) can benefit adults' long-term health, but evidence for elderly patients is scarce. This study examines mid and long-term health outcomes of OSA surgery in patients over 65 compared to the standard Continuous Positive Airway Pressure (CPAP) therapy.

Methods: This retrospective cohort study compared OSA treatment with surgery against CPAP (no previous surgery) in patients aged 65 and older using healthcare data from 2010-2023. CPT, ICD-9, and ICD-10 codes from deidentified EMR were used. We assessed cardiovascular, cerebrovascular, and metabolic outcomes at mid-term (6mo-1yr) and long-term (1-5yrs) using incidence rates and risk assessment. Independent variables included intervention type and follow-up period.

Results: Among geriatric patients, 578 had OSA surgery against 13,243 treated with CPAP only from 2010 to 2023. At 1-5 years post-index, surgery significantly reduced risks of: cardiomyopathy (p=0.013, CI:0.266-0.855), composite cardiovascular events (p < 0.001, CI:0.422-0.785), composite endocrine events (p < 0.001, CI:0.38-0.746), diabetes (p=0.019, CI:0.347-0.908), dysrhythmias (p=0.003, CI:0.369-0.811, high e-value:1.8), and hypertension (p < 0.001, CI:0.135-0.568, high e-value:2.9). At 6 months-1 year, surgery significantly reduced: composite cardiovascular events (p < 0.001, CI:0.22-0.582, high e-value:2.8), diabetes (p=0.038, CI:0.142-0.944), dysrhythmias (p=0.002, CI:0.143-0.658, high e-value:2.4), hypertension (p < 0.001, CI:0.00135-0.365), and ischemic disease (p=0.017, CI:0.247-0.874). No statistically significant difference was observed in Alzheimer's, dementia, or stroke risks at any period, and ischemic disease at 1-5 years post-index.

Conclusions: In this study, surgical treatment options for OSA in older patients showed reduced risk in developing long-term cardiovascular and metabolic systemic health complications when compared to CPAP therapy. This finding highlights the potential significance of surgery as a viable therapeutic option for the elderly.

Co-Author(s)

YA

Yousif Alammar, MD

Medical Intern
King Saud University Medical City
Riyadh, United States

Disclosure information not submitted.

Presenting Author(s)

Elaine Costa, MD, MSc

MD, MSc
Stanford University, Dept. of OHNS
Palo Alto, CA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Elaine Costa, MD, MSc

MD, MSc
Stanford University, Dept. of OHNS
Palo Alto, CA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Pedro M. Gomes de Oliveira, MD

Clinical Assistant Professor
Stanford University School of Medicine
Palo Alto, CA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
GH

Gavin Hui, MD

Atropos Health, United States

Disclosure information not submitted.
JM

Jananee A. Muralidharan, MD

Clinical Informatics
Atropos Health
Bengaluru, Karnataka, India

Disclosure information not submitted.
HM

Honor Magon, MD

Atropos Health, United States

Disclosure information not submitted.
RC

Robson Capasso, MD

Professor
Stanford University
Palo Alto, CA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

RC

Robson Capasso, MD

Professor
Stanford University
Palo Alto, CA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.