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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Autores principales: SALDÍAS P,FERNANDO, JORQUERA A,JORGE, DÍAZ P,ORLANDO
Lenguaje:Spanish / Castilian
Publicado: Sociedad Médica de Santiago 2010
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Acceso en línea:http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872010000800001
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spelling 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 &#8805; 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 &#8805; 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
institution Scielo Chile
collection Scielo Chile
language Spanish / Castilian
topic Oximetry
Polysomnography
Sleep apnea, obstructive
spellingShingle 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 &#8805; 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 &#8805; 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
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