Valor predictivo de la historia clínica y oximetría nocturna en la pesquisa de pacientes con apneas obstructivas del sueño / Predictive value of clinical features and nocturnal oximetry for the detection of obstructive sleep apnea syndrome
Rev. méd. Chile
;
138(8): 941-950, ago. 2010. tab
Artigo
em Espanhol
| LILACS
| ID: lil-567604
ABSTRACT
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 andMethods:
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 percent confidence intervals (CI) 1.59-10.0, p = 0.003), BMI ≥ 26 kg/m² (OR 3.68; 95 percentCI 1.59-8.49, p = 0.002), smoking (OR 2.29; 95 percent CI 1.17-4.47, p = 0.015), Epworth index > 13 (OR 2.65; 95 percent CI 1.35-5.23, p = 0.005) and duration of symptoms over 2 years (OR 2.35; 95 percent 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 percent (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.
Texto completo:
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Índice:
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Assunto principal:
Oximetria
/
Fumar
/
Apneia Obstrutiva do Sono
/
Distúrbios do Sono por Sonolência Excessiva
/
Pescoço
Tipo de estudo:
Estudo diagnóstico
/
Estudo prognóstico
/
Fatores de risco
Limite:
Adolescente
/
Adulto
/
Idoso
/
Aged80
/
Feminino
/
Humanos
/
Masculino
Idioma:
Espanhol
Revista:
Rev. méd. Chile
Assunto da revista:
Medicina
Ano de publicação:
2010
Tipo de documento:
Artigo
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