Valor predictivo de la historia clínica y oximetría nocturna en la pesquisa de pacientes con apneas obstructivas del sueño
Background: Obstructive sleep apnea syndrome (OSA) is an important cause of morbidity and mortality in adults. Aim: To evaluate the diagnostic value of clinical features and oximetric data to screen for obstructive sleep apnea before performing polysomnograpy or respiratory polygraphy. Material and...
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Sociedad Médica de Santiago
2010
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oai:scielo:S0034-988720100008000012010-12-21Valor predictivo de la historia clínica y oximetría nocturna en la pesquisa de pacientes con apneas obstructivas del sueñoSALDÍAS P,FERNANDOJORQUERA A,JORGEDÍAZ P,ORLANDO Oximetry Polysomnography Sleep apnea, obstructive Background: Obstructive sleep apnea syndrome (OSA) is an important cause of morbidity and mortality in adults. Aim: To evaluate the diagnostic value of clinical features and oximetric data to screen for obstructive sleep apnea before performing polysomnograpy or respiratory polygraphy. Material and Methods: We studied 328 consecutive adult patients referred for snoring or excessive daytime sleepiness to a sleep clinic in whom a standardized questionnaire and the Sleepiness Epworth Scale were performed and body mass index (BMI), cervical circumference (CC), and nocturnal oximetry were measured. Results: Fifty three percent (n = 173) had evidence of clinically significant OSA (apnea/hypopnea index (AHI) > 15 events/h). Patients with OSA were more likely to be male, obese (BMI ≥ 26 kg/m²), smokers, to have a thick neck (CC > 41 cm), and to have a significant greater prevalence of relative reported apneas and excessive daytime sleepiness, as determined by Epworth scale. Male gender (Odds ratio (OR): 4.00; 95% confidence intervals (CI): 1.59-10.0, p = 0.003), BMI ≥ 26 kg/m² (OR: 3.68; 95%CI: 1.59-8.49, p = 0.002), smoking (OR: 2.29; 95% CI: 1.17-4.47, p = 0.015), Epworth index > 13 (OR: 2.65; 95% CI: 1.35-5.23, p = 0.005) and duration of symptoms over 2 years (OR: 2.35; 95% CI: 1.20-4.58, p = 0.012) were significant independent predictors of OSA. In nocturnal oximetry, the lowest SpO2 (SpO2 min) and the length of registries below 90% (CT-90) were independent predictors of OSA and both correlated significantly with AHI (r = -0.49 and r = 0.46 respectively, p < 0.001). Conclusions: No single factor was usefully predictive of obstructive sleep apnea. However, combining clinical features and oximetry data may be appropriate to detect clinically significant OSA patients.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.138 n.8 20102010-08-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872010000800001es10.4067/S0034-98872010000800001 |
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Scielo Chile |
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Scielo Chile |
language |
Spanish / Castilian |
topic |
Oximetry Polysomnography Sleep apnea, obstructive |
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Oximetry Polysomnography Sleep apnea, obstructive SALDÍAS P,FERNANDO JORQUERA A,JORGE DÍAZ P,ORLANDO Valor predictivo de la historia clínica y oximetría nocturna en la pesquisa de pacientes con apneas obstructivas del sueño |
description |
Background: Obstructive sleep apnea syndrome (OSA) is an important cause of morbidity and mortality in adults. Aim: To evaluate the diagnostic value of clinical features and oximetric data to screen for obstructive sleep apnea before performing polysomnograpy or respiratory polygraphy. Material and Methods: We studied 328 consecutive adult patients referred for snoring or excessive daytime sleepiness to a sleep clinic in whom a standardized questionnaire and the Sleepiness Epworth Scale were performed and body mass index (BMI), cervical circumference (CC), and nocturnal oximetry were measured. Results: Fifty three percent (n = 173) had evidence of clinically significant OSA (apnea/hypopnea index (AHI) > 15 events/h). Patients with OSA were more likely to be male, obese (BMI ≥ 26 kg/m²), smokers, to have a thick neck (CC > 41 cm), and to have a significant greater prevalence of relative reported apneas and excessive daytime sleepiness, as determined by Epworth scale. Male gender (Odds ratio (OR): 4.00; 95% confidence intervals (CI): 1.59-10.0, p = 0.003), BMI ≥ 26 kg/m² (OR: 3.68; 95%CI: 1.59-8.49, p = 0.002), smoking (OR: 2.29; 95% CI: 1.17-4.47, p = 0.015), Epworth index > 13 (OR: 2.65; 95% CI: 1.35-5.23, p = 0.005) and duration of symptoms over 2 years (OR: 2.35; 95% CI: 1.20-4.58, p = 0.012) were significant independent predictors of OSA. In nocturnal oximetry, the lowest SpO2 (SpO2 min) and the length of registries below 90% (CT-90) were independent predictors of OSA and both correlated significantly with AHI (r = -0.49 and r = 0.46 respectively, p < 0.001). Conclusions: No single factor was usefully predictive of obstructive sleep apnea. However, combining clinical features and oximetry data may be appropriate to detect clinically significant OSA patients. |
author |
SALDÍAS P,FERNANDO JORQUERA A,JORGE DÍAZ P,ORLANDO |
author_facet |
SALDÍAS P,FERNANDO JORQUERA A,JORGE DÍAZ P,ORLANDO |
author_sort |
SALDÍAS P,FERNANDO |
title |
Valor predictivo de la historia clínica y oximetría nocturna en la pesquisa de pacientes con apneas obstructivas del sueño |
title_short |
Valor predictivo de la historia clínica y oximetría nocturna en la pesquisa de pacientes con apneas obstructivas del sueño |
title_full |
Valor predictivo de la historia clínica y oximetría nocturna en la pesquisa de pacientes con apneas obstructivas del sueño |
title_fullStr |
Valor predictivo de la historia clínica y oximetría nocturna en la pesquisa de pacientes con apneas obstructivas del sueño |
title_full_unstemmed |
Valor predictivo de la historia clínica y oximetría nocturna en la pesquisa de pacientes con apneas obstructivas del sueño |
title_sort |
valor predictivo de la historia clínica y oximetría nocturna en la pesquisa de pacientes con apneas obstructivas del sueño |
publisher |
Sociedad Médica de Santiago |
publishDate |
2010 |
url |
http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872010000800001 |
work_keys_str_mv |
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