Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, MN.
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, MN.
Chest. 2011 Nov;140(5):1192-1197. doi: 10.1378/chest.10-2625. Epub 2011 May 19.
The Berlin Questionnaire (BQ) has been used to identify patients at high risk for sleep-disordered breathing (SDB) in a variety of populations. However, there are no data regarding the validity of the BQ in detecting the presence of SDB in patients after myocardial infarction (MI). The aim of this study was to determine the performance of the BQ in patients after MI.
We conducted a cross-sectional study of 99 patients who had an MI 1 to 3 months previously. The BQ was administered, scored using the published methods, and followed by completed overnight polysomnography as the "gold standard." SDB was defined as an apnea-hypopnea index of ≥ 5 events/h. The sensitivity, specificity, and positive and negative predictive values of the BQ were calculated.
Of the 99 patients, the BQ identified 64 (65%) as being at high-risk for having SDB. Overnight polysomnography showed that 73 (73%) had SDB. The BQ sensitivity and specificity was 0.68 and 0.34, respectively, with a positive predictive value of 0.68 and a negative predictive value of 0.50. Positive and negative likelihood ratios were 1.27 and 0.68, respectively, and the BQ overall diagnostic accuracy was 63%. Using different apnea-hypopnea index cutoff values did not meaningfully alter these results.
The BQ performed with modest sensitivity, but the specificity was poor, suggesting that the BQ is not ideal in identifying SDB in patients with a recent MI.
柏林问卷（BQ）已被用于在各种人群中识别患有睡眠呼吸障碍（SDB）的高风险患者。然而，关于 BQ 在检测心肌梗死后（MI）患者中 SDB 存在的有效性，尚无数据。本研究旨在确定 BQ 在 MI 患者中的表现。
我们对 99 例 MI 后 1 至 3 个月的患者进行了横断面研究。使用发表的方法对 BQ 进行评分，并在完成整夜多导睡眠图作为“金标准”后进行。SDB 定义为呼吸暂停低通气指数≥5 次/小时。计算了 BQ 的敏感性、特异性、阳性和阴性预测值。
在 99 例患者中，BQ 确定了 64 例（65%）存在 SDB 的高风险。整夜多导睡眠图显示，73 例（73%）患有 SDB。BQ 的敏感性和特异性分别为 0.68 和 0.34，阳性预测值为 0.68，阴性预测值为 0.50。阳性和阴性似然比分别为 1.27 和 0.68，BQ 的总体诊断准确性为 63%。使用不同的呼吸暂停低通气指数截断值并不能显著改变这些结果。
BQ 的敏感性适中，但特异性较差，表明 BQ 不太适合识别近期 MI 患者的 SDB。
