Rapid Risk Stratification for Obstructive Sleep Apnea, Based on Snoring Severity and Body Mass Index
| Autor: | Kelvin C. Lee, Andrew J. Kleinberger, Omar Burschtin, Luc G. T. Morris, Lisa A. Liberatore |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
Male medicine.medical_specialty Polysomnography Risk Assessment Severity of Illness Index Body Mass Index 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Internal medicine Severity of illness Humans Medicine Prospective Studies Sleep study 030223 otorhinolaryngology Aged Sleep Apnea Obstructive medicine.diagnostic_test business.industry Epworth Sleepiness Scale Snoring Sleep apnea Middle Aged medicine.disease nervous system diseases respiratory tract diseases Obstructive sleep apnea ROC Curve Otorhinolaryngology 030220 oncology & carcinogenesis Predictive value of tests Physical therapy Female Surgery business Body mass index |
| Zdroj: | Otolaryngology–Head and Neck Surgery. 139:615-618 |
| ISSN: | 1097-6817 0194-5998 |
| DOI: | 10.1016/j.otohns.2008.08.026 |
| Popis: | OBJECTIVE: It is unclear whether all snoring patients require polysomnography, and there are no highly sensitive clinical predictors of sleep apnea. Our objective was to develop a simple clinical screening test for OSA in snoring patients. STUDY DESIGN: Prospective, IRB-approved study at a university sleep disorders center. SUBJECTS AND METHODS: In 211 patients undergoing polysomnography, snoring severity, Epworth sleepiness scale, body mass index, demographic, and sleep study data were collected. Receiver operating characteristic (ROC) analysis and Pearson correlation were used to develop a sensitive screening test for OSA. RESULTS: Snoring severity score (SSS) and BMI were the two most accurate predictors of OSA on the ROC curve. A bipartite threshold of SSS 4 or BMI 26 carried sensitivity of 97.4%, specificity of 40%, positive predictive value of 82.3%, and negative predictive value of 84.2% for moderate/severe OSA. Patients at high risk were those with BMI 32 (89% PPV) or SSS 7 (92% PPV). CONCLUSIONS: The statistic most predictive of OSA was snoring severity. Combining this with BMI yielded a highly sensitive screening test for moderate/severe OSA. This clinical assessment may be useful in risk-stratifying patients for polysomnography and therapy, facilitating deferred work-up in low-risk patients and expedited therapy in high-risk patients. © 2008 American Academy of Otolaryngology‐Head and Neck Surgery Foundation. All rights reserved. |
| Databáze: | OpenAIRE |
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